| 出生体重与婴儿期生长速度对一年级小学生体重状态的影响 |
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| 引用本文： | 陈迪迪,林丹,叶佩琪,李云,黄俊,温晓飒,史慧静.出生体重与婴儿期生长速度对一年级小学生体重状态的影响[J].中国学校卫生,2022,43(6):813-816. |
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| 作者姓名： | 陈迪迪 林丹 叶佩琪 李云 黄俊 温晓飒 史慧静 |
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| 作者单位： | 1.上海市闵行区疾病预防控制中心学校卫生科，201101 |
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| 基金项目： | 复旦-闵行康联体合作项目研究2019FM11闵行区自然科学研究课题2020MHZ011 |
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| 摘 要： | 目的 纵向研究出生体重状态与婴儿期生长速度模式对一年级小学生体重状态的影响，为生命早期的预防和干预政策制定提供理论基础。 方法 针对上海市闵行区2019年入学的小学一年级新生，收集其当年学校常规体检信息，并回顾性收集其出生和产后随访信息，选取12月龄体格检查信息完整的4 434名小学生作为研究对象。采用多元线性回归模型分析婴儿期生长速度与小学一年级时体质量指数(BMI)值及其Z评分的关系，同时采用广义线性模型分析出生体重状态和婴儿期生长速度模式对小学一年级时超重和肥胖患病的影响并进行分层分析。 结果 纳入研究的小学生婴儿期生长速度与小学一年级BMI值及其Z评分均存在线性关系β值(β值95%CI)=0.30(0.24~0.35)，0.12(0.10~0.15)，P值均 < 0.01]。小于、适于和大于胎龄儿人群中均出现婴儿期追赶生长的个体。出生体重状态为大于胎龄儿和婴儿期出现追赶生长是儿童小学一年级超重和肥胖患病的独立危险因素(RR=1.31~1.55，P值均 < 0.05)。分层分析显示，追赶生长会增加适于胎龄儿小学一年级超重和肥胖的患病风险RR值(RR值95%CI)=1.74(1.42~2.14)，1.87(1.56~2.26)]，且会增加大于和小于胎龄儿小学一年级肥胖的患病风险RR值(RR值95%CI)=3.74(1.04~13.49)，3.24(1.62~6.46)](P值均 < 0.05)。在发生婴儿期追赶生长的人群中，出生体重状态为大于胎龄会增加儿童一年级时肥胖患病的风险(RR=2.60，95%CI=1.35~5.02，P < 0.01)，但不增加超重的患病风险(P=0.13)。 结论 出生体重状态与婴儿期生长速度模式对小学一年级儿童的超重和肥胖患病都具有影响，建议关注大于和适于胎龄儿的生命早期生长发育并扩大婴儿期追赶生长的监测范围。
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| 关 键 词： | 出生体重 生长 体重 线性模型 学生 |
| 收稿时间： | 2021-12-16 |
Influence of birth weight and infancy growth patterns on weight status among first-grade primary school pupils |
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| Affiliation: | 1.Department of School Health, Minhang District Center for Disease Control and Prevention, Shanghai (201101), China |
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| Abstract: | Objective To explore the influence of birth weight and growth patterns during infancy on overweight and obesity among first-grade primary school pupils, so as to provide a theoretical basis for the formulation of early life prevention and intervention policies. Methods In 2019, data related to routine physical examinations were collected for primary school pupils in the Minhang District of Shanghai, and information regarding birth and follow-ups was collected retrospectively. Physical examination data of 4 434 pupils at 12 months of age were obtained. A multiple linear regression model was used to analyze the relationship between growth patterns during infancy and body mass index (BMI) in the first grade of primary school. A generalized linear model was employed to analyze the relationship between birth weight and growth patterns during infancy and overweight and obesity in the first grade of primary school. A hierarchical analysis was conducted. Results A linear relationship was observed between growth patterns during infancy and BMI and the BMI Z-score of first-grade primary school pupils β(β 95%CI)=0.30(0.24-0.35), 0.12(0.10-0.15), P < 0.01]. In addition to subjects classified as small for gestational age (SGA), catch-up growth during infancy was identified among subjects who were classified as appropriate for gestational age (AGA) and large for gestational age (LGA). LGA at birth and catch-up growth during infancy were independent risk factors for overweight and obesity among first-grade primary school children (RR=1.31-1.55, P < 0.05). The hierarchical analysis showed that catch-up growth increased the risk of overweight and obesity among first-grade primary school pupils classified as AGA RR(RR 95%CI)=1.74(1.42-2.14), 1.87(1.56-2.26)], and increased the risk of obesity among first-grade primary school pupils classified as SGA and LGA RR(RR 95%CI)=3.74(1.04-13.49), 3.24(1.62-6.46)](P < 0.05). Among those who exhibited catch-up growth during infancy, LGA increased the risk of obesity among first-grade primary school pupils (RR=2.60, 95%CI=1.35-5.02, P < 0.01), but not the risk of being overweight (P=0.13). Conclusion Birth weight and growth patterns during infancy have an impact on overweight and obesity among children in the first grade of primary school. It is suggested that attention should be paid to growth and physical development in early life for those classified as LGA and AGA, and catch-up growth in children should be closely monitored. |
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