目的 分析儿童0~3岁体质量指数(BMI)轨迹,探讨孕期体重增长模式对儿童BMI轨迹的影响。方法 选取2021—2022年在苏州市姑苏区分娩的孕妇,追踪其儿童0~3岁时的身高和体重。采用潜类别增长模型构建儿童 0~3岁BMI变化轨迹,通过曲线下面积(AUC)计算孕妇孕期体重累积AUC和增量AUC。采用logistic回归探讨孕期体重AUC与儿童0~3岁BMI轨迹的关联。结果 共10 590对母婴数据纳入分析。儿童0~3岁BMI轨迹拟合为3类:适宜生长组、先高后降组和快速生长组。以适宜生长组为参考,多因素logistic回归分析显示,与体重累积AUC Q1组相比,Q2组(OR=1.26,95%CI:1.04~1.51)、Q3组(OR=1.28,95%CI:1.07~1.54)、Q4组(OR=1.38,95%CI:1.15~1.66)均增加儿童BMI先高后降的风险,Q4组亦增加儿童快速生长的风险(OR=1.24,95%CI:1.05~1.46)。母亲孕期体重增长模式与子代BMI轨迹风险的关联在男女童中存在差异。结论 儿童0～3岁BMI轨迹可分为适宜生长、先高后降和快速生长三组模式,母亲孕期不适宜的体重增长模式会增加儿童0～3岁呈现先高后降和快速生长BMI轨迹的风险。
Abstract
Objective To analyze the body mass index (BMI) trajectories in children aged 0 - 3 years, and to explore the impact of maternal gestational weight gain (GWG) patterns on these trajectories. Methods A cohort of pregnant women who delivered in Gusu District, Suzhou City from 2021—2022 was selected, and their children's height and weight were tracked from birth to 3 years of age.Latent class growth modeling (LCGM) was used to identify distinct BMI trajectories.The area under the curve (AUC) was calculated to determine cumulative GWG AUC and incremental GWG AUC during pregnancy.Multivariable logistic regression was employed to examine the associations between GWG AUC quartiles and the identified BMI trajectory groups. Results Data from 10 590 mother-child pairs were analyzed.Three distinct BMI trajectories were identified: appropriate growth group, rise-then-decline group, and rapid growth group.Using the appropriate growth group as reference, multivariable logistic regression analysis showed that compared to the first quartile of cumulative GWG AUC, the second (OR=1.26, 95% CI: 1.04 - 1.51), third (OR=1.28, 95% CI: 1.07 - 1.54), and fourth (OR=1.38, 95% CI: 1.15 - 1.66) quartiles were associated with an increased likelihood of belonging to the rise-then-decline group.The fourth quartile of cumulative GWG AUC also increased the risk of the rapid growth group (OR=1.24, 95% CI: 1.05 - 1.46).Stratified analysis suggested that the associations between GWG patterns and offspring BMI trajectory risks differed between boys and girls. Conclusions Children's BMI trajectories from 0 - 3 years can be categorized into three patterns: appropriate growth, rise-then-decline, and rapid growth.Suboptimal maternal GWG patterns are associated with an increased risk of children exhibiting either the rise-then-decline or rapid growth trajectory patterns.
关键词
生长轨迹 /
孕期体重增长模式 /
曲线下面积 /
儿童
Key words
growth trajectory /
gestational weight gain pattern /
area under the curve /
children
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基金
苏州市应用基础研究(医疗卫生)科技创新项目(SYWD2024034)
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