Abstract: Objective To identify the prevalence and the risk factors of different body proportions in children under 2 years of age, so as to provide theoretical basis for making related prevention and control measures. Methods Cross-sectional data of 8 474 children under 2 years old (0~<2 years) from May 2020 to May 2022 were retrieved through the Children′s Growth and Development Assessment and Follow-up System of the Department of Child Health Care, Shanghai Children′s Hospital for a retrospective study according to real-world research methods. Physical data were measured by medical professionals, and the children′s birth and parents′ conditions were collected retrospectively. A numerical table was constructed and the SPSS 26.0 software was used to analyze the prevalence and risk factors of different body proportions. χ² test was used for comparison between groups and multi-factor Logistic regression analysis was used for regression. Results The study included 3 813 boys and 4 661 girls under 2 years of age in routine health check-ups, of whom the overall detection rates for emaciation, overweight and obesity were 1.5%, 19.0% and 7.8% respectively. The detection rates of overweight and obesity in boys were higher than those in girls(χ²=17.597, 12.653, P＜0.01). The risk of overweight and obesity was increased in children with birth weight > 4 000g, larger for gestational age and larger head circumference, and the risk of obesity was higher in children with birth weight <2 500g than that in the normal group(P＜0.01). Children with smaller head circumference and small for gestational age were more likely to emaciation(P＜0.05).Children with overweight or obese parents were at a higher risk of developing overweight and obesity than the normal population, and caesarean section was also a risk factor for obesity in childhood(RR=1.33, 95%CI:1.15-1.53, P＜0.01). Logistic regression analysis showed that boys, head circumference, birth weight in relation to gestational age and parental BMI were valid early warning indicators of overweight and obesity in children (P＜0.01). Conclusion With a high detection rate of overweight and obesity in children under 2 years of age and the persistence of emaciation, early prevention and intervention are needed for the healthy development of children′s physical fitness.

Key words: children, emaciation, overweight, obesity

摘要： 目的 了解2岁以下儿童不同体型匀称度的流行现状及其风险因素,为制定早期干预措施提供依据。方法 数据来源于2020—2022年上海市儿童医院儿童保健科生长发育评估与随访系统,共计纳入8 474名2岁以下儿童,测量体格生长发育指标,并回顾性收集儿童出生及父母情况等构建数值表,采用SPSS 26.0软件分析不同体型匀称度的流行情况和风险因素,组间比较采用χ²检验,回归采用多因素Logistic回归分析。结果 研究纳入2岁以下常规健康体检男童3 813例,女童4 661例,其中消瘦、超重、肥胖总检出率分别为1.5%,19.0%,7.8%,男童超重、肥胖的检出率均高于女童(χ²分别为17.597、12.653,P＜0.01)。出生体质量>4 000g、大于胎龄儿、头围偏大儿童发生超重和肥胖的风险均增加,出生体质量＜2 500g儿童发生肥胖的风险高于正常组,头围偏小、小于胎龄儿人群的消瘦风险较高(P＜0.05)。父母超重或肥胖的儿童发生超重肥胖风险高于正常人群(P＜0.05),剖宫产为儿童期肥胖的风险因素(RR=1.33,95%CI:1.15~1.53,P＜0.01)。Logistic回归分析结果显示,男童、头围、相对于胎龄的出生体质量、父母BMI是儿童超重、肥胖的有效预警指标(P＜0.01)。结论 2岁以内儿童超重、肥胖检出率较高, 消瘦现象仍然存在,儿童体格良性发展需多方共同努力,实现早期预防和干预。

关键词: 儿童, 消瘦, 超重, 肥胖