儿童肥胖与出生体重、胎龄及宫内营养的关系

目的 了解不同出生体重、胎龄及宫内营养状况与儿童期肥胖之间的关系,为围产期干预提供依据.方法 对上海市东北区域10所小学6～10岁共2395名儿童进行体格检查.收集每位儿童的出生资料,分析出生体重、胎龄以及宫内营养状况与儿童期肥胖的关系.结果 出生时巨大儿(出生体重≥4000 g)儿童期发生肥胖的危险是正常出生体重儿的1.55倍(OR=1.55,95%CI:1.17～2.05,x2=9.380,P=0.002);与足月儿相比,早产儿和过期儿的儿童期肥胖检出率有升高趋势,但差异无统计学意义(OR=1.38,95%CI;0.82～2.3,x2=1.448,P=0.229;OR:1.34,95%CI:0.71～2.51,x2=0.834,P=0.361);大于胎龄儿(LGA)儿童期发生肥胖的危险是适于胎龄儿(AGA)的1.38倍(OR=1.38,95%CI:1.05～1.82,x2=5.206,P=0.023).结论 巨大儿、大于胎龄儿均为发生儿童期肥胖的高危因素.

Birth weight,gestational age at birth and intrauterine nutrition affect the incidence of childhood obesity

Objective To determine the relationship between birth weight,gestational age at birth,intrauterine nutritional status and childhood obesity.Methods Physical examinations of 2395 6 to 10-year-old children were performed,and questionnaire survey was used to collect their birth data.The relationship between birth weight,gestational age at birth and childhood obesity was analyzed.Results The risk of childhood obesity for macrosomia at birth (birth weight≥4000 g) was 1.55 times as much as that of children with normal birth weight (OR= 1.55,95%CI:1.17-2.05,x2 =9.380,P=0.002),and the risk of obesity for large for gestational age (LGA) babies was 1.38 times as much as that of appropriate for gestational age babies (AGA) (OR= 1.38,95%CI:1.05-1.82,x2=5.206,P=0.023).Compared with the normal term infants,the rate of obesity in preterm infants and postdated child increased,but there was no statistical difference (OR= 1.38,95 CI:0.82-2.3,x2 = 1.448,P= 0.229;OR= 1.34,95%CI:0.71-2.51,x2=0.834,P=0.361).Conclusions Macrosomia and LGA are the risk factors for childhood obesity.