巨大儿0～18月龄生长随访分析

Growth follow-up of infants born macrosomia at their life of 0 to 18 months

目的调查巨大儿出生后的生长情况以及18月龄时超重发生率和相关因素。方法 84例无基础疾病的巨大儿纳入研究,定期随访其生长情况,并比较分析18月龄时超重的相关因素。结果 18月龄时,84例巨大儿中有24%超重(20/84),男婴的超重比例高于女婴(30%vs 11%,P<0.05)。18月龄时超重组的6月龄超重比例及12月龄超重比例均高于非超重组(80%vs 22%,P<0.01;80%vs 13%,P<0.01)。Spearman相关分析显示,巨大儿出生体重、0～6月体重增长、7～12月体重增长和13～18月体重增长与其18月龄时按身长的体重Z评分均呈正相关(P<0.05),其中0～6月体重增长与18月龄时Z评分相关性最高(r=0.597,P<0.01)。结论对出生巨大儿,应重点干预出生后6个月内的体重快速增长,尤其是男婴,以预防幼儿期肥胖。

Objective To study the growth of macrosomic infants,the incidence of overweight and the factors related to overweight at 18 months old. Methods Eighty-four macrosomic infants without underlying diseases were enrolled in this study.Their growth was followed up regularly.Factors related to overweight at 18 months old were investigated. Results Twenty infants（24%） showed as overweight at 18 months old.More male infants were overweight than female infants（30% vs 11%;P〈0.05）.The overweight infants at 18 months old had a higher proportion of overweight at 6 months（80% vs 22%;P〈0.01） and at 12 months old（80% vs 13%;P〈0.01） than non-overweight infants at 18 months.The spearman correlation analysis demonstrated that weight-for-length Z score at 18 months old was positively correlated with birth weight and weight gain between 0 to 6 months,7 to 12 months and 13 to 18 months（P〈0.05）.The strongest correlation was observed between weight gain form 0 to 6 months and weight-for-length Z score at 18 months old（r=0.597,P〈0.01）. Conclusions More attention should be given to the aspect of rapid weight gain in the first 6 months of life in macrosomic infants,especially males,to prevent obesity in early childhood.