Objectives: We aimed to identify potential risk factors, both individually and interactively, associated with overweight and obesity among preschool–aged children, and further to create a risk prediction nomogram model.

Results: After graded multivariable adjustment, maternal body mass index (BMI) (odds ratio, 95% confidence interval, P under China criteria: 1.07, 1.05 to 1.10, <0.001), maternal pre–pregnancy BMI (1.08, 1.05 to 1.10, <0.001), breastfeeding duration (0.86, 0.76 to 0.98, 0.019), and sleep duration (0.95, 0.90 to 1.00, 0.042) were found to be independently and consistently associated with the significant risk of childhood overweight or obesity under three different growth criteria. Further analyses revealed the four significant factors acted in an additive manner, especially for the interaction between maternal obesity, sleep duration, and breastfeeding. Finally, a risk prediction nomogram model was created for childhood overweight or obesity based on significant and conventional attributes under each criterion.

Conclusions: Our findings provide evidence that the four significant factors are associated with the risk of childhood overweight or obesity in an additive manner.

Methods: Using a stratified cluster random sampling strategy, 7222 preschool–aged children were analyzed. Childhood overweight and obesity are defined according to the China criteria and two widely–used international growth criteria.