出生体重对1~18月龄婴幼儿体格发育的影响

目的探讨出生体重对1~18月龄婴幼儿体格发育的影响。方法应用回顾性队列研究方法,收集2018年1月至2019年12月在广州市花都区妇幼保健院出生及进行体格检查的婴幼儿资料。不同出生体重组婴幼儿1~18月龄的体重、身长及重量指数(PI)变化的差别以及趋势分别采用单因素协方差分析以及Mann-Kendall趋势检验。广义估计方程模型用于估计出生体重对1~18月龄婴幼儿体重、身长及PI变化的影响。结果本研究共纳入1937名婴儿,其中男婴1063名(54.88%);出生体重平均(3.18±0.42)kg,小于胎龄儿(SGA)发生率为7.95%,大于胎龄儿(LGA)发生率为5.01%。随着月龄增长,SGA、适于胎龄儿(AGA)、LAG的体重/身长增量均呈增加趋势(均P<0.01),而PI增量则均呈减少趋势(均P<0.01)。在调整相关协变量后,SGA、AGA、LAG 6~18月龄的体重增量、1~18月龄的身长增量及1月龄的PI增量差异有统计学意义(P<0.05或P<0.01)。广义估计方程模型结果显示,与AGA相比,SGA的体重增量(β=-0.15)、身长增量(β=-0.79)、PI增量(β=-0.03)均较少,LGA的身长增量(β=0.78)较多。结论出生体重对1~18月龄婴幼儿体格发育有影响。医护人员应做好母亲孕期保健及产后婴幼儿的膳食营养指导,加强早期生长监测和干预,提高婴幼儿发育质量。

Effects of birth weight on growth and development among infants aged 1~18 months

Objective To explore the effects of birth weight on growth and development among infants aged 1-18 months. Methods A retrospective cohort study was conducted to collect the information on infants born and undergoing physical examination in the Maternal and Child Health Hospital of Huadu District, Guangzhou, from January 2018 to December 2019. The differences and the trends of the changes in weight, length, and ponderal index （PI） among infants with different birth weights from 1 to 18 months were analyzed by One way covariance analysis method and the Mann-Kendall trend test, respectively. The generalized estimation equation models were used to estimate the effect of birth weight on the changes in weight, length, and PI of infants aged 1-18 months. Results A total of 1 937 infants were included in the study, including 1 063 males （54.88%）. The average birth weight was （3.18±0.42） kg, the incidence of small for gestational age （SGA） was 7.95%, and that of large for gestational age （LGA） was 5.01% for all the infants. With the increase of month age, both weight and length increment of SGA, appropriate for gestational age （AGA）, and LGA increased （all P<0.01）, while PI increment decreased （all P<0.01）. After adjusting for related confounders, there were significant differences in body weight increment from 6 to 18 months, body length increment from 1 to 18 months, and PI increment at 1 month among SGA, AGA, and LGA （P <0.05 or P<0.01）. Generalized estimating equation models showed that compared to AGA, the weight increment （β=-0.15）, length increment （β=-0.79）, and PI increment （β=-0.03） of SGA were less, respectively, while the height increment （β=0.78） of LGA was higher. Conclusions The birth weight of infants influences the growth and development of infants aged 1-18 months. Medical staff should do an excellent job in maternal health care during pregnancy and dietary nutrition guidance for postpartum infants, strengthen early growth monitoring and intervention and improve the quality of infant development.