巨大儿与正常出生体重儿0~24月龄BMI轨迹模式比较的纵向研究  

Comparison of BMI Trajectory Pattern Between Macrosomia and Normal Birth Weight Infants Aged 0 to 24 Months:A Longitudinal Study

作　　者：熊超 陈凯 章一鸣 刘建军[1] 周爱芬[1] Xiong Chao;Chen Kai;ZhangYiming(Wuhan Children’s Hospital(Wuhan Maternal and Child Healthcare Hospital),Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院),武汉430014

出　　处：《华中科技大学学报（医学版）》2022年第5期645-650,共6页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：国家自然科学基金资助项目(No.81903331);武汉市卫生健康委员会科研项目(No.WG16D03)。

摘　　要：目的比较巨大儿与正常出生体重儿0~24月龄内超重/肥胖发生情况以及体质量指数(body mass index,BMI)轨迹模式的差异。方法以武汉市妇幼保健信息管理系统为基础,选取2011年6月~2013年6月期间在武汉市中心城区出生的儿童作为研究对象,包括60548例正常出生体重儿和4515例巨大儿。通过Mann-Whitney检验比较两组儿童在各随访时点(1、3、6、8、12、18和24月龄)的体格发育状况。采用基于群组的轨迹模型拟合研究对象0~24月龄内的BMI轨迹,并使用Logistic回归模型分析巨大儿、正常出生体重儿与不同BMI轨迹模式之间的联系。结果巨大儿在各随访时点的超重/肥胖发生率均显著高于正常出生体重儿。研究对象在0~24月龄存在3种BMI轨迹模式,即BMI增长较慢组(13513,20.8%)、BMI增长适宜组(39722,61.0%)和BMI增长较快组(11828,18.2%)。巨大儿是出现增长较快型BMI轨迹模式的危险因素(OR=2.10,95%CI:1.94~2.26)。结论应加强对巨大儿出生后的体格发育监测,并采取适宜的预防保健措施以降低巨大儿在婴幼儿期出现超重/肥胖以及增长较快型BMI轨迹的风险。Objective To compare the overweight/obesity occurrence and BMI trajectory patterns between macrosomia and normal birth weight infants aged 0-24 months.Methods Data was drawn from the Wuhan Maternal and Child Health Information Management System,which contained the birth records and health examination data of children born from June 2011 to June 2013 in Wuhan.In all,60548 normal birth weight infants and 4515 macrosomia were recruited as the research objects.Mann-Whitney test was used to compare the physical status of normal birth weight infants and macrosomic infants at each follow-up point(1,3,6,8,12,18,and 24 months).The group-based trajectory model was used to fit the BMI trajectory of the research subjects from 0 to 24 months.The logistic regression was used to analyze the association between macrosomia,normal birth weight infants and different patterns of BMI trajectory.Results The prevalence of overweight/obesity was higher among macrosomia than normal birth weight infants at each follow-up point.There were three BMI trajectory patterns in the study subjects from 0 to 24 months,including the slow BMI growth group(13513,20.8%),the moderate BMI growth group(39722,61.0%)and the fast BMI growth group(11828,18.2%).Macrosomia was the risk factor for the fast growth BMI trajectory pattern(OR=2.10,95%CI:1.94-2.26).Conclusion The physical development monitor of macrosomia should be strengthened,and appropriate preventive and health care measures should be taken,which would be helpful to reduce the risk of overweight/obesity and fast growth BMI trajectory among macrosomia.

关 键 词：巨大儿 体质量指数 基于群组的轨迹模型 纵向研究 

分 类 号：R723.14[医药卫生—儿科]