【目的】 探讨与儿童超重肥胖相关的母亲妊娠期及围生期因素,为儿童超重肥胖的预防提供科学依据。 【方法】 采用分层整群随机抽样方法,随机抽取无锡3个地区的3 230名10~14岁儿童,进行问卷调查和体格检查。母亲妊娠期及围生期的相关资料则由当地妇女围产保健数据库获得。 【结果】 收回有效问卷2 870份,有效应答率88.9%。儿童超重肥胖检出率为13.62%,其中男生检出率为11.67%,女生为1.95%,且两者间差异有统计学意义(P<0.05)。单因素分析发现,母亲文化程度及妊娠初期BMI较高的儿童易超重肥胖(P<0.05),而未发现母亲其他妊娠期及围生期因素如妊高症、胎儿窘迫、孕龄等与儿童超重肥胖存在关联。在调整了性别、出生体重、饮食习惯、户外活动等可能影响BMI的因素后,母亲妊娠初期BMI与儿童超重肥胖的关联仍然存在(P<0.05),母亲妊娠初期BMI每增加1 kg/m2,儿童BMI增加0.05 kg/m2,而未发现母亲文化程度与儿童超重肥胖的关联。 【结论】 母亲妊娠初期BMI可能是影响儿童超重肥胖的发生。适当控制母亲妊娠初期BMI,可能减少儿童超重肥胖的发生风险。
Abstract
【Objective】 To explore the maternal gestational and perinatal factors related with overweight and obesity in childhood. 【Methods】 With a stratified cluster random sampling method,3 230 children aged 10 to 14 in three districts of Wuxi were surveyed with questionnaire and physical examination was performed.The data on maternal gestational and perinatal status were gotten from the local Maternal Gestational and Perinatal Health Care Databank. 【Results】 Among all the objects,2 870 questionnaires were qualified and the response rate was 88.9%.The incidence of overweight and obesity was 13.62%,in which boys' was 11.67% and girls' was 1.95%.The incidence of overweight and obesity of boys was much higher than that of girls (P<0.01).The results of univariate analysis indicated that the higher of maternal education and BMI in early pregnancy,the easier for the happen of overweight and besity in childhood (P<0.05).Other maternal gestational and perinatal factors might be not associated with overweight and besity in childhood.The result of multiple linear regression analysis indicated maternal BMI in early pregnancy might be the independent influencing factors of BMI in childhood (P<0.05).The BMI in childhood would increase 0.05 kg/m2 with 1 kg/m2 increase in maternal BMI in early pregnancy. 【Conclusion】 Maternal BMI in early pregnancy may be the independent influencing factors of overweight and obesity in childhood and controlling maternal BMI in early pregnancy could prevent overweight and obesity in childhood.
关键词
母亲妊娠期因素 /
围生期因素 /
儿童 /
超重 /
肥胖
Key words
maternal gestational factors /
maternal perinatal factors /
children /
overweight /
obesity
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参考文献
[1] de OM,Blossner M,Borghi E.Global prevalence and trends of overweight and obesity among preschool children[J].Am J Clin Nutr,2010,92(5):1257-1264.
[2] Gonzalez-Suarez C,Worley A,Grimmer-Somers K,et al.School-based interventions on childhood obesity:a meta-analysis[J].American Journal of Preventive Medicine,2009,37(5):418-427.
[3] 中国肥胖问题工作组.中国学龄儿童青少年超重肥胖筛查体质指数分类[J].中华流行病学杂志,2004,25(2):97-102.
[4] Loaiza S,Coustasse A,Urrutia-Rojas X,et al.Birth weight and obesity risk at first grade in a cohort of Chilean children[J].Nutr Hosp,2011,26(1):214-219.
[5] National Board of Health and Welfare.Public Health Report 2009.[http:// www.socialstyrelsen.se/publikationer2009/2009-126-71],(in Swedish).
[6] Troiano RP,Flegal KM.Overweight children and adolescents:description,epidemiology,and demographics[J].Pediatrics,1998,101(3Pt2):497-504.
[7] Ogden CL,Flegal KM,Carroll MD,et al.Prevalence and trends in overweight among US children and adolescents,1999~2000[J].JAMA,2002,288(14):1728-1732.
[8] Ogden CL,Carroll MD,Flegal KM.High body mass index for age among US children and adolescents,2003~2006[J].JAMA,2008,299(20):2401-2405.
[9] 中国学生体质与健康研究组.2005年中国学生体质与健康调研报告[M].北京:高等教育出版社,2007:8-10.
[10] Ben-Shlomo Y,Kuh D.A life course approach to chronic disease epidemiology:conceptual models,empirical challenges and interdisciplinary perspectives[J].Int J Epidemiol,2002,31(2):285-293.
[11] Lucas A.Programming by early nutrition in man[J].Ciba Found Symp,1991,156:38-50.
[12] Wells JC,Chomtho S,Fewtrell MS.Programming of body composition by early growth and nutrition[J].Proc Nutr Soc,2007,66(3):423-434.
[13] Power C,Parsons T.Nutritional and other influences in childhood as predictors of adult obesity [J].Proc Nutr Soc,2000,59(2):267-272.
[14] Heude B,Kettaneh A,Rakotovao R,et al.Anthropometric relationships between parents and children throughout childhood:the fleurbaix-laventie ville santé study[J].Int J Obes (Lond),2005,29(10):1222-1229.
[15] Johnson W,Kyvik KO,Skytthe A,et al.Education modifies genetic and environmental influences on BMI[J].PLo S One,2011,6(1):e16290.
[16] Druet C,Stettler N,Sharp S,et al.Prediction of childhood obesity by infancy weight gain:an individual-level meta-analysis[J].Paediatric and Perinatal Epidemiology,2012,26(1):19-26.
[17] Elisabeth M,Martin L,Maria R.Early life factors and being overweight at 4 years of age among children in Malm?,Sweden[J].BMC Public Health,2010,10:764-772.
基金
国家自然科学基金委员会资助项目(81072364)
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