妊娠期糖尿病与儿童超重肥胖的相关性研究  

Correlation between gestational diabetes mellitus exposure and offspring obesity

作　　者：贾朝霞[1] 赵永鲜[1] 黄丽丽[1] 王军华[1] 王朝[1] 武明辉[1] JIA Zhao-xia;ZHAO Yong-xian;HUANG Li-li;WANG Jun-hua;WANG Zhao;WU Ming-hui(Department of Information and Statistics,Beijing Obstetrics and Gynecology Hospital.Capital Medical University,Beijing 100026.China)

机构地区：[1]首都医科大学附属北京妇产医院群体信息科,北京100026

出　　处：《中国儿童保健杂志》2021年第7期717-720,共4页Chinese Journal of Child Health Care

基　　金：首都卫生发展科研专项资助(首发2020-2-2111);中国疾病预防控制中心妇幼保健中心“母婴营养与健康研究项目”(2019FYH001)。

摘　　要：目的探讨宫内暴露于妊娠期糖尿病是否增加儿童3岁内发生超重肥胖的风险,为预防儿童肥胖提供科学依据。方法采用前瞻性队列研究,自2014年9月—2015年8月从北京市16个社区入组符合标准的儿童2 275名,从新生儿期随访至3岁。结果宫内暴露于妊娠期糖尿病的儿童在1、2、3岁时的BMI均高于非暴露组,但差异无统计学意义(P>0.05)。出生时为巨大儿(OR=2.01,95%CI:1.40-2.89)、母亲孕前体重指数较高(OR=1.09,95%CI:1.06-1.13)、母亲孕期体重增加过多(OR=1.01,95%CI:0.99-1.03)是儿童1岁内超重肥胖的危险因素(P<0.05);家庭人均收入较高(OR=0.83,95%CI:0.71-0.98)是儿童1岁内超重肥胖的保护因素(P<0.05)。出生时为巨大儿(OR=1.66,95%CI:1.07-2.58)、母亲孕前体重指数较高(OR=1.14,95%CI:1.09-1.18)、母亲孕期体重增加过多(OR=1.02,95%CI:1.00-1.04)是儿童2岁内超重肥胖的危险因素(P<0.05);家庭人均收入较高(OR=0.61,95%CI:0.49-0.75)和纯母乳喂养持续6个月(OR=0.61,95%CI:0.45-0.84)是儿童2岁内超重肥胖的保护因素(P<0.05)。出生时为巨大儿(OR=1.89,95%CI:1.23-2.91)、母亲孕前体重指数较高(OR=1.14,95%CI:1.09-1.18)也是儿童3岁内超重肥胖的危险因素(P<0.05);家庭人均收入较高(OR=0.66,95%CI:0.54-0.81)和纯母乳喂养持续6个月(OR=0.55,95%CI:0.40-0.75)是儿童3岁时超重肥胖的保护因素(P<0.05)。辅食添加时间与3岁内儿童超重肥胖无相关性。结论为了减少儿童在3岁内发生超重肥胖,应严格控制孕妇孕前和孕期的体重,尽可能地坚持纯母乳喂养6个月。Objective To investigate the risk of overweight/obesity during 3 years old in children exposed to gestational diabetes mellitus(GDM), in order to provide scientific basis for prevention of childhood obesity. Methods Totally 2 275 eligible children were enrolled in this prospective cohort study from September 2014 to August 2015 in 16 communities of Beijing, and were followed up to 3 years old. Their height and weight were measured at each regular physical examination. Results The body mass index(BMI) of children exposed to GDM was higher than that in the non-exposure group at 1, 2 and 3 years old, but the differences were not significant(P>0.05). The factors that increased the risk of children being overweight and obese within 1 year old included macrosomia(OR=2.01, 95%CI:1.40—2.89), mother with high BMI before pregnancy(OR=1.09, 95%CI:1.06—1.13) and excessive weight gain during pregnancy(OR=1.01, 95%CI:0.99—1.03), while high family income was a protective factor(OR=0.83, 95%CI:0.71—0.98). The factors increasing the risk of children being overweight and obese within 2 years old were macrosomia(OR=1.66, 95%CI:1.07—2.58), mother with high BMI before pregnancy(OR=1.14, 95%CI:1.09—1.18) and excessive weight gain during pregnancy(OR=1.02, 95%CI:1.00—1.04), while factors decreased the risk included higher level of family incomes(OR=0.61, 95%CI:0.49—0.75) and exclusive breastfeeding for 6 months(OR=0.61, 95%CI:0.45—0.84). Factors increasing the risk of children being overweight and obese within 3 years old were macrosomia(OR=1.89, 95%CI:1.23—2.91) and mother with high BMI before pregnancy(OR=1.14, 95%CI:1.09—1.18),while high family incomes(OR=0.66, 95%CI: 0.54—0.81) and exclusive breastfeeding for 6 months(OR=0.55, 95%CI:0.40—0.75) were protective factors for overweight and obese within 3 years old. Conclusion In order to reduce the overweight and obesity of children within 3 years old, the weight of pregnant women before and during pregnancy should be strictly controlled, and exclusive breastf

关 键 词：儿童肥胖 妊娠期糖尿病 纯母乳喂养 

分 类 号：R714.256[医药卫生—妇产科学] R723.14[医药卫生—临床医学]