母亲孕期被动吸烟与女生超重肥胖对月经初潮提前的影响  

Effects of maternal passive smoking during pregnancy and girls’ overweight/obesity on the age at menarche in urban areas of Guangzhou

作　　者：杨轮 梁健平 敖丽萍 张广川 陆爽 黄玮浩 杨翌 刘丽 YANG Lun;LIANG Jianping;AO Liping;ZHANG Guangchuan;LU Shuang;HUANG Weihao;YANG Yi;LIU Li(School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510310,China;不详)

机构地区：[1]广东药科大学公共卫生学院,广州510310 [2]广州市中小学卫生健康促进中心

出　　处：《中国学校卫生》2020年第7期1012-1014,1018,共4页Chinese Journal of School Health

基　　金：国家自然科学基金项目(81874271);广州市科技计划项目(201607010143);广东省科技计划项目(2016A020215155)。

摘　　要：目的探讨母亲孕期被动吸烟及女生超重肥胖对女生月经初潮年龄(age at menarche,AAM)的影响,为促进儿童青少年健康成长提供参考。方法基于2016年中学新生体检工作,采用方便抽样法对广州市城区26所中学的2722名初一女生进行问卷调查和体格检查。应用Logistic回归模型分析女生超重肥胖、母亲孕期被动吸烟与女生AAM的关系,采用四向分解法探讨女生超重肥胖在母亲孕期被动吸烟对女生AAM提前中的中介效应。结果女生月经来潮率为90.82%(2472/2722)。月经初潮中位年龄为12.00岁,初潮提前率为34.91%(863/2472)。与母亲孕期无被动吸烟的女生相比,母亲孕期被动吸烟≤3 d/周的女生AAM提前的风险增加32%(OR调整=1.32,95%CI=1.06~1.65),母亲孕期被动吸烟>3 d/周的女生AAM提前的风险增加58%(OR调整=1.58,95%CI=1.21~2.07)。超重肥胖女生AAM提前的风险比非超重肥胖的女生增加77%(OR调整=1.77,95%CI=1.36~2.31)。四向分解结果显示,母亲孕期被动吸烟导致女儿AAM提前的风险中,79.60%归因于母亲孕期被动吸烟的直接效应(P<0.01)。结论女生超重肥胖和母亲孕期被动吸烟与女生AAM提前关联。母亲孕期被动吸烟对女生AAM提前的影响方式可能以直接作用为主。Objective To investigate the effect of maternal passive smoking during pregnancy and girls’ overweight/obesity on the age at menarche( AAM), and to provide a reference for improving healthy development of children and adolescents. Methods Based on the school entrance physical examination in 2016, a cross-section study was conducted by convenient sampling method, in a total of 2 722 students of 7 th grade, from 26 middle schools in urban areas of Guangzhou. Multivariate logistic regression model was used to investigate the relationship between maternal passive smoking during pregnancy and girls’ overweight/obesity and AAM. A four-way decomposition method was used to explore the mediated effect of girls’ overweight/obesity on the relationship between maternal passive smoking during pregnancy and AAM. Results The proportion of girls who had menstruate was90.82%( 2 472/2 722). The median AAM was 12.00 years old, with an early menarche rate of 34.91%( 863/2 472). Compared with girls whose mother hadn’ t passive smoking during pregnancy, the risk of early AAM in girls with mother passive smoking during pregnancy≤3 days/week increased by 32%( OR = 1.32, 95%CI = 1.06-1.65), the risk in girls with maternal passive smoking during pregnancy>3 days/week increased by 58%( OR = 1. 58, 95% CI = 1. 21-2. 07). Multivariate Logistic regression analysis showed that, overweight or obesity girls had a 77% higher risk of early AAM than non-overweight/obesity girls( OR = 1.77, 95%CI= 1.36-2. 31). The four-way decomposition analysis showed 79. 60% of early AAM risk could be accounted by maternal passive smoking during pregnancy( P<0.01). Conclusion Girls’ overweight/obesity and maternal passive smoking during pregnancy were associated with early menarche. The effect on daughters’ age at menarche is mainly in a direct effect manner of maternal passive smoking during pregnancy.

关 键 词：烟草烟污染 超重 肥胖症 月经初潮 回归分析 学生 女(雌)性 

分 类 号：R723.14[医药卫生—儿科] R173[医药卫生—临床医学]