基于中国母婴营养与健康队列婴儿6月龄内不同喂养方式与3~5岁儿童体格生长的关联研究  

Study on the association between different feeding methods during the first six months after birth and physical growth of children aged 3 to 5 years based on the Taicang and Wuqiang mother-child cohort study in China

作　　者：段一凡 杨振宇 毕烨 刘长青[2] 赵永丽 谷旭阳 段景涛 赵华 赖建强[4] Duan Yifan;Yang Zhenyu;Bi Ye;Liu Changqing;Zhao Yongli;Gu Xuyang;Duan Jingtao;Zhao Hua;Lai Jianqiang(National institute for nutrition and health,China CDC/Key Laboratory of Public Nutrition and Health,National Health Commission of the People′s Republic of China/Key Laboratory of Human Breast Milk Science,China CDC.Beijing 100050,China;Hebei province center for disease prevention and control.Shijiazhuang 050000,China;Wuqiang county center for disease control and prevention,Hengshui 053300,China;Office of Chronic Disease and Ageing Health Management,China CDC,Beijing 102206,China)

机构地区：[1]中国疾病预防控制中心营养与健康所、国家卫生健康委公共营养与健康重点实验室、中国疾病预防控制中心母乳科学研究重点实验室,北京100050 [2]河北省疾病预防控制中心,石家庄050000 [3]武强县疾病预防控制中心,衡水053300 [4]中国疾病预防控制中心慢病和老龄健康管理处,北京102206

出　　处：《中华预防医学杂志》2025年第1期30-38,共9页Chinese Journal of Preventive Medicine

基　　金：中国母婴营养与健康队列研究(102393220020070000016)。

摘　　要：目的探讨6月龄内不同喂养方式对3~5岁儿童体格生长的影响。方法数据来自“中国母婴营养与健康队列研究(TAWS)”河北武强子队列,将2016年11月至2020年9月出生的婴儿纳入研究,并在1、2、3、6、8、12、18、24月龄和3~5岁时进行随访。根据6月龄内喂养方式将研究对象分为“纯母乳喂养组”和“配方奶喂养组”。收集儿童出生和8~24月龄喂养信息,以及学龄前期膳食、身体活动及患病情况。测量儿童学龄前期的身高、体重,计算年龄别身高Z评分(HAZ)、年龄别体重Z评分(WAZ)、年龄别体重指数Z评分(BAZ)、生长迟缓率、低体重率、消瘦率、超重率和肥胖率。通过多重线性回归和多因素logistics模型,调整人口社会学特征、出生信息、8~24月龄喂养行为及学龄前期膳食、身体活动和患病情况等,分析6月龄内喂养方式对3~5岁儿童体格生长的影响。结果共纳入1233名儿童,男女童分别为629和604名;3、4、5岁儿童分别为436、406和391名。纯母乳喂养组754名,配方奶喂养组479名。6月龄内引入配方奶喂养的儿童在3~5岁时的HAZ(0.09±0.99)、WAZ(0.24±1.07)、BAZ(0.26±1.11)均高于纯母乳喂养组[HAZ、WAZ、BAZ分别为(-0.04±0.92)、(0.06±1.02)、(0.11±1.08)];调整混杂因素后,多重线性回归分析结果显示,与纯母乳喂养组相比,配方奶喂养组HAZ、WAZ和BAZ的β(95%CI)值分别为0.16(0.06~0.25)、0.17(0.06~0.29)、0.15(0.02~0.27)。调整混杂因素后,多因素logistic回归模型分析结果显示,纯母乳喂养组与配方奶喂养组儿童学龄前期的生长迟缓、低体重、消瘦、超重、肥胖的发生风险差异均无统计学意义,OR(95%CI)值分别为1.04(0.41~2.62)、0.99(0.27~3.57)、1.63(0.53~4.95)、1.08(0.66~1.74)、1.58(0.70~3.60)。结论6月龄内纯母乳喂养并未增加儿童在学龄前期发生营养不足的风险,但6月龄内配方奶的引入显著增加学龄前期儿童的体格生长发育水平。Objective To explore the association between different feeding methods during the first six months after birth and the physical growth of children aged 3 to 5 years.Methods Data were from the"Taicang and Wuqiang mother-child cohort study"(TAWS)in China.Children were enrolled at birth between November 2016 and September 2020 and followed up at 1,2,3,6,8,12,18,and 24 months,as well as at ages 3 to 5 years.Based on feeding methods within six months of age,children were categorized into an"exclusive breastfeeding group"and a"formula-feeding group".Birth-related information and feeding practices between 8 and 24 months were collected,alongside dietary habits,physical activity,and illness during preschool years.Height and weight of preschool children were measured to calculate height-for-age Z-score(HAZ),weight-for-age Z-score(WAZ),body mass index-for-age Z-score(BAZ),and the rates of stunting,underweight,wasting,overweight,and obesity.After adjusting for demographic factors,birth-related information,feeding practices between 8 to 24 months,preschool dietary habits,physical activity,and health status,multiple linear regression and logistic regression were adopted to analyze the influence of feeding methods within six months of age on the physical growth of children aged 3 to 5 years.Results A total of 1233 children were included,comprising 629 boys and 604 girls.The number of children aged 3,4,and 5 years was 436,406,and 391,respectively.About 754 children were categorized into the exclusive breastfeeding group and 479 into the formula-feeding group.Children who were introduced to formula milk within six months of age had higher HAZ(0.09±0.99),WAZ(0.24±1.07)and BAZ(0.26±1.11)scores at ages 3 to 5 compared to the exclusive breastfeeding group[HAZ,WAZ,and BAZ were(-0.04±0.92),(0.06±1.02)and(0.11±1.08),respectively].After adjusting for confounding factors,multiple linear regression analysis showed that theβ(95%CI)values for HAZ,WAZ and BAZ in the formula-feeding group were 0.16(0.06-0.25),0.17(0.06-0.29)and 0.15(0.

关 键 词：母乳喂养 儿童 学龄前 前瞻性研究 队列研究 体格生长 

分 类 号：R179[医药卫生—妇幼卫生保健]