辅食添加对中国西部农村地区婴幼儿体重指数生长轨迹影响的出生队列研究

目的 描述婴幼儿体重指数(BMI)生长轨迹,探讨辅食添加的时间和质量对婴幼儿BMI生长轨迹的影响.方法 采用队列研究设计,对符合纳入条件的1388名新生儿进行随访,1岁内每三个月一次,1～2岁每半年一次,随访内容包括:体格测量、喂养、户外活动、患病等.采用潜变量增长混合模型拟合0～2岁BMI生长轨迹,运用多水平Logi...

Birth cohort study on the effects of complementary feeding on body mass index growth trajectories from birth to 24 months in rural Western China

Objective To describe the body mass index(BMI) growth trajectories from birth to 24 months old, and to examine the effect of time and quality of complementary feeding on the BMI growth trajectories. Methods A total of 1 388 eligible births were followed up from birth to 24 months old. Height and weight were measured at birth, 3, 6, 9, 12, 18 and 24 months old. The demographic data, feeding, activity and diseases data were also collected prospectively. Latent growth mixture modeling method was used to model the BMI growth trajectories. Mixed-effects Logistic regression analysis was used to examine the effect of time and quality of complementary feeding on BMI growth trajectories. Results Finally 1 255 (90.4%) children were available for study. Six BMI trajectory patterns were identified and labeled as follows:normative growth (6.5%), normal-accelerating growth (4.8%), normal-decelerating growth (28.0%), lower-persistent growth (32.9%),rapid growth (17.8%), and rapid-accelerating growth (10.0%). Taking normative growth group as reference, multivariate Logistic regression analysis indicated that introduction of complementary feeding before 6 months old could significantly increase the risk of rapid growth (OR=2.16, 95%CI:1.01-4.83) and rapid-accelerating growth (OR=3.13, 95%CI :1.35-7.25). After adjusting for confounding factors, the relationship remained significant (aOR=2.41,95%CI:1.03-5.63;aOR=3.46,95%CI:1.41-8.48). The lower feeding index score at 1 year old might significantly increase the risk of rapid growth (OR=2.50,95%CI: 1.23-5.05). This association persisted after adjustment for confounding factors (OR=2.35,95%CI:1.10-5.07). Conclusions In study area, the main BMI growth trajectory patterns include normal-decelerating growth, lower-persistent growth and rapid growth. The time and quality of complementary feeding may influence the excess weight gain during infancy.