常州出生巨大儿幼儿时期生长发育状况的研究

An investigation of growth status of macrosomias during infancy

目的对巨大儿和正常出生体重儿在婴幼儿期超重和肥胖的发生情况进行比较，以便采取积极有效的干预措施改善儿童的生长发育状况。方法随机选择足月巨大儿145例和足月正常出生体重儿145例（对照组），进行体格测量及数据评价。结果巨大儿组平均体重、平均身高1周岁时为11．27±1，24kg、78，64±2．62cm，2周岁时为14．01±1．69kg、91．10±3．18cm。2岁时身体质量指数为16．83±1．46kg／m^2，各指标均高于对照组，并有统计学差异（P〈0．05）；巨大儿组和对照组幼儿期超重和肥胖儿的发生率，1周岁时分剐为17．24％和4．14％,Χ^2=13．039，P〈0．05；2周岁时分别为11．03％和4．83％，Χ^2=3．825．P=0．05。巨大儿造成1岁幼儿超重和肥胖的风险是正常出生体重儿的4．83倍（P〈0．05）。结论胎儿期的肥胖可影响至婴幼儿期，预防肥胖症的发生应该从孕前开始，应注重出生后第1年的喂养方式．提倡母乳喂养．以降低后期肥胖的发生率。

Objective To compare morbidity rate of overweight and obesity in infancy between macrosomias and neonates with nomal birth weight so as to adopt effective measures to improve growth and development of the children. Methods 145 term macrosonias were selected randomly and other 145 term neonates with nomal birth weight were selected as controls. The growth and development status and morbidity rates of obesity and overweight of all infants during infancy were compared. Results The average body weight, body height of children at one-year old and two-year old and their BMI in the macrosomia group were greater than those of children in the control group（ at one year old：11. 27 ± 1.24kg vs 10.22 ± 1.05kg,78.64 ± 2.62cm vs 76.56 ± 2.46cm; at two years old： 14.01± 1.69kg vs 12.75 ± 1.39kg, 91.10 ± 3.18cm vs 89.32 ±3.07cm ;BMI at two years old ： 16.83± 1.46 vs 15.93 ± 1.20）, there were significant differences between the two groups（all P〈0.05）. The morbidity rate of obesity and overweight in macrosomia group was 17.24% and that was 4.14% in the control group at one-year old （Χ^2 = 13. 039, P 〈 0.05 ） , and that was 11.03 % in the macrosomia group and 4.83 % in the control group at two years old（Χ^2 = 3. 825, P = 0.05） , respectively. The risk of obesity and overweight in the macrosomia group at one-year old was 4.83 folds as compared with the control group and the difference was significant（P 〈 0.05）. Conclusion Our data suggest that there is a close relationship between fetal obesity and infantile obesity. Therefore, prevention of obesity should start from pregestational period, more attention should be paid to feeding patterns in the first year after birth and breast feeding should be advocated so as to reduce mobidity rate of obesity in infancy.