广州市儿童生命早期因素与超重肥胖的关联

张婧姝; 桂曌环; 谭恺韫; 陈亚军

doi:10.16835/j.cnki.1000-9817.2021.09.031

广州市儿童生命早期因素与超重肥胖的关联

doi: 10.16835/j.cnki.1000-9817.2021.09.031

中山大学公共卫生学院妇幼卫生学系, 广东广州 510080

基金项目:

国家自然科学基金项目 81673193

详细信息

作者简介:
张婧姝(1996-)，女，陕西汉中人，在读硕士，主要研究方向为环境健康和儿童慢性病

通讯作者:
陈亚军，E-mail：chenyj68@mail.sysu.edu.cn

中图分类号: R723.14 R179
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- 文章访问数: 781
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- 被引次数: 0
出版历程
- 收稿日期: 2020-11-19
- 修回日期: 2021-01-10
- 网络出版日期: 2021-09-24
- 刊出日期: 2021-09-24

Association of early-life factors with the incidence of overweight and obesity among primary school students in Guangzhou

Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou(510080), China

摘要

摘要: 目的探讨广州市6~11岁儿童生命早期因素与超重肥胖之间的关系, 为儿童超重肥胖的预防提供科学依据。方法基线采用分层整群随机抽样的方法, 于2017年抽取广州市5所小学共5 172名学生作为研究对象, 进行2年的随访, 最终纳入学生3 315名。通过问卷调查收集学生的生命早期因素, 并测量基线和随访中身高和体重等指标。采用Logistic回归分析儿童生命早期因素与超重肥胖的关系。结果广州市6~11岁儿童超重肥胖发生率为8.7%。校正混杂因素后, Logistic回归分析显示, 母亲孕前消瘦的儿童超重肥胖发生风险比母亲孕前正常体重的儿童降低了46%(OR=0.54, 95%CI=0.38~0.76);母亲孕期增重过多的儿童超重肥胖发生风险比孕期增重正常的儿童增加了55%(OR=1.55, 95%CI=1.14~2.10);与自然分娩儿童相比, 剖宫产的儿童超重肥胖发生风险增加了30%(OR=1.30, 95%CI=1.00~1.68)(P值均 < 0.05)。结论母亲孕期增重过多和剖宫产增加儿童超重肥胖的发生风险, 母亲孕前消瘦降低儿童超重肥胖的发生风险。
- 生命周期各时期 /
- 超重 /
- 肥胖症 /
- 回归分析 /
- 儿童
Abstract: Objective To investigate the associations between early-life factors and the incidence of overweight and obesity and to provide a reference for childhood overweight and obesity prevention. Methods A total of 5 172 children aged 6-11 years from 5 primary schools in Guangzhou were enrolled using stratified random cluster sampling method. After two-years follow up, 3 315 children were included in the final analysis. Questionnaire was used to collect children's early-life factors. Height and weight were measured objectively at baseline and follow-up. Results The incidence of overweight and obesity was 8.7% in children. After adjustment for confounders, Results from the Logistic regression analysis showed that maternal pre-pregnancy underweight was negatively associated with the incidence of childhood overweight and obesity(OR=0.54, 95%CI=0.38-0.76)(P < 0.05). While excessive gestational weight gain during pregnancy(OR=1.55, 95%CI=1.14-2.10) and caesarean section (OR=1.30, 95%CI=1.00-1.68) were positively associated with the incidence of childhood overweight and obesity(P < 0.05). Conclusion Both excess gestational weight gain and caesarean section would increase the risk of the overweight and obesity of their offspring, while maternal pre-pregnancy underweight would reduce the risk of childhood overweight and obesity.
- Life cycle stages /
- Overveight /
- Obesity /
- Regression analysis /
- Child

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表 1 不同组别儿童超重肥胖检出率比较

Table 1. General characteristics of the children in the study at baseline

变量	选项	人数	超重肥胖人数	χ²值	P值
性别	男	1 680	177(10.5)	14.66	< 0.01
	女	1 635	111(6.8)
父母文化程度	初中及以下	107	12(11.2)	7.46	0.06
	高中或中专	353	21(5.9)
	大专或职大	653	69(10.6)
	本科及以上	2 145	179(8.3)
肥胖家族史	有	459	49(10.7)	2.60	0.11
	无	2 814	236(8.4)
户外活动时间/(h·d^-1)	< 1	1 155	98(8.5)	5.69	0.13
	1~1.9	1 507	119(7.9)
	2~4	448	47(10.5)
	>4	135	17(12.6)
母亲孕前体重	正常	2 447	241(9.8)	15.95	< 0.01
	消瘦	805	43(5.3)
	超重或肥胖	63	4(6.3)
孕期增重	正常	1 342	101(7.5)	12.08	< 0.01
	不足	1 106	87(7.9)
	过多	867	100(11.5)
分娩方式	自然分娩	1 541	120(7.8)	2.94	0.09
	剖宫产	1 774	168(9.5)
出生体重	适于胎龄儿	2 770	240(8.7)	0.72	0.70
	小于胎龄儿	370	30(8.1)
	大于胎龄儿	175	18(10.3)
喂养方式	纯母乳喂养	1 000	98(9.8)	7.08	0.03
	混合喂养	1 752	131(7.5)
	人工喂养	563	59(10.5)
注： ( )内数字为检出率/%。部分项目存在人数缺失。

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表 2 生命早期因素对儿童期超重肥胖发生的Logistic回归分析[OR值(OR值95%CI)]

Table 2. Adjusted odds ratio and 95% confidence interval for the incidence of overweight and obesity related to early-life factors[OR(OR 95%CI)]

自变量	男生(n=1 680)	女生(n=1 635)	合计(n=3 315)
孕前体重
正常	1.00	1.00	1.00
消瘦	0.50(0.32~0.78)^*	0.62(0.36~1.07)	0.54(0.38~0.76)^*
超重或肥胖	0.52(0.12~2.24)	0.99(0.23~4.37)	0.70(0.25~1.97)
孕期增重
正常	1.00	1.00	1.00
不足	0.81(0.53~1.22)	1.58(0.98~2.56)	1.07(0.78~1.45)
过多	1.55(1.06~2.29)^*	1.56(0.94~2.59)	1.55(1.14~2.10)^*
分娩方式
自然分娩	1.00	1.00	1.00
剖宫产	1.38(0.99~1.94)	1.15(0.77~1.74)	1.30(1.00~1.68)^*
出生体重
适于胎龄儿	1.00	1.00	1.00
小于胎龄儿	0.85(0.49~1.46)	0.85(0.42~1.73)	0.84(0.54~1.29)
大于胎龄儿	1.65(0.86~3.15)	1.10(0.46~2.61)	1.37(0.82~2.29)
喂养方式
纯母乳喂养	1.00	1.00	1.00
混合喂养	0.71(0.49~1.04)	0.90(0.57~1.42)	0.79(0.59~1.06)
人工喂养	1.16(0.73~1.82)	1.31(0.73~2.35)	1.23(0.86~1.75)
注： *P < 0.05。

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