儿童1岁内体重指数加速生长的回顾性队列研究  

Retrospective cohort study on rapid body mass index gain in infants from birth to 1 year old

作　　者：赵晓丽 廖艳[2] 李莉敏[2] 谢传波 顾莉萍[2] 郜蕊 胡晓云[1] 高建慧[2] 李秀红[1] 文孝忠 

机构地区：[1]中山大学公共卫生学院妇幼卫生系,广东广州510080 [2]中山市博爱医院,广东中山528403 [3]中山大学肿瘤防治中心,广东广州510080 [4]南山区妇幼保健院保健部,广东深圳518000 [5]纽约州立大学布法罗分校儿科系行为医学教研室,美国纽约ny14214

出　　处：《中国儿童保健杂志》2018年第3期258-261,共4页Chinese Journal of Child Health Care

基　　金：国家自然科学基金项目(81673197);国家自然科学基金项目(81302437)

摘　　要：目的了解儿童1岁内体重指数加速生长的影响因素,为确定出生胎龄和出生体重对儿童加速生长是否存在交互作用提供参考依据。方法采用回顾性队列研究,以中山市电子妇幼保健系统中2011年1月-2013年5月出生,并完成1岁内常规儿童保健的786名儿童为研究对象,采用单因素和多因素Logistic回归分析,对体重指数加速生长的影响因素进行分析。结果 1)多因素回归分析显示,出生胎龄、出生体重及母亲学历是儿童1岁内体重指数发生加速生长的影响因素。相对于足月儿,早产儿(Adjusted OR=19.88,95%CI:10.24~38.59)易于发生加速生长;相对于适于胎龄儿,小于胎龄儿(Adjusted OR=4.59,95%CI:2.56~8.23)易于发生加速生长,而大于胎龄儿(Adjusted OR=0.29,95%CI:0.12~0.69)不易发生加速生长;与母亲学历初中及以下比,母亲学历为本科及以上(Adjusted OR=0.38,95%CI:0.18~0.78)的儿童不易发生加速生长。2)交互作用分析显示,出生胎龄和出生体重对婴儿1岁内体重指数加速生长无交互作用(P>0.05)。结论早产和小于胎龄儿是影响婴儿1岁内体重指数发生加速生长的独立危险因素,母亲高学历为保护因素。Objective To examine the predictors of rapid gain of body mass index （BMI） in infants from birth to 1 year old,and to povide the reference basis about whether there was an interaction between gestational age and birth weight per- centile on rapid gain of BMI in infants. Methods A retrospective cohort study was conducted using the electronic medical record system of Maternal and Child Health Care in Zhongshan, Guangdong, China. A total of 786 infants born form January 2011 to May 2013 were errolled in this study,and completed their one-year regular child visit within 3 months before or after 12 months of age. Univariate and multivariable Logistic regression analysis were used to identify significant predictors. Re- sults Multivariable Logistic regression analysis indicated that gestational age,birth weight percentile and maternal educa- tion were significant predictors of rapid gain of BMI in infants from birth to 1 year old. Compared with full-term infants, pro- term infants were more likely （OR= 19.88,95 -CI：10.24-38.59） to have rapid gain of BMI in infants. Compared with ap- propriate for gestational age （AGA） infants, small for gestational age （SGA） infants were more likely （OR= 4.59,95 % CI： 2.56 - 8.23） to have rapid gain of BMI, while large for gestational age （LGA） infants were less likely （OR = 0.29,95 G CI： 0. 1240.69） to have rapid gain of BMI. Children whose mothers were with college degree or higher education level were less likely （OR=0.38,95GCI..0.18-0.78） to have rapid BMI gain than children whose mothers were with middle school or lower education level. There was no significant interaction between gestational age and birth weight percentile on rapid gain of BMI in infants （P〈0.05）. Conclusions Preterm and SGA are independent risk factors （without interaction） for rapid gain of BMI in infants from birth to 1 year of age,while high maternal education may protect against rapid BMI gain.

关 键 词：加速生长 早产 小于胎龄儿 适于胎龄儿 大于胎龄儿 

分 类 号：R179[医药卫生—妇幼卫生保健]