上海市5岁内女童乳房早发育患病率及影响因素的分析

Incidence rate of premature breast development and its causative factors among five-year-old girls in Shanghai municipality

目的 了解 90年代初上海市 5岁内女童乳房发育状况及社会生物医学的影响因素。方法 对 80年代末该市两社区初婚夫妇队列婚后 6年内避孕、生育及儿童健康状况的随访调查及体检。结果 由该队列出生女童乳晕增大状况估计 90年代初上海市 5岁内女孩乳房早发育的患病率为 15 .15‰ (5 2 / 3432 )。其中5 9.6 % (31/ 5 2 )是由本次随访医生首次体检发现 ,在非首次发现的 2 1例女童中 ,仅 5例 (2 3.8% )治疗后增大已消失。检查显示 87.2 %的女童乳晕增大伴结节为双侧 ,74 .5 %乳晕增大范围在 1.0～ 1.4cm。 16 .2 %生后服过滋补品。由拟合Logistic回归模型显示曾服用营养保健品、平均月收入偏低夫妇或孕期其母亲从未采取自我保健优生措施等的女童 ,其乳房增大的机会均略增多 (OR值分别为 4 .38、2 .5 2及 2 .17,可信限分别为 2 .4 1～7.96 ,1.2 6～ 5 .0 2及 1.11～ 4 .2 3)。结论 上海市 90年代初 5岁内女童乳房早发育的患病率为 15 .15‰。除过早给小儿服用营养保健品为一重要因素外 ,改善家庭经济及做好孕期保健 。

Objective To investigate the prevalence of premature breast development in girls aged less than 5 years in the early 1990 s in Shanghai Municipality and its social and biomedical factors.Methods A follow up study with a cohort of couples who married for one year in the late 1980 s was carried out to the 6th year after their marriage to investigate their contraceptive intake, reproductive conditions, and health status of their babies . The breast development status of all of the girls born by these wives was examined at the last time of the follow up.Results The prevalence of premature breast development for this cohort of girls was 15.15 ‰ (52/3432) and 59.6 % of them (31/52)were detected at the last time of visiting. Only 5 cases recovered (23.8 %) among the 21 girls who had been detected prior to the last time of visiting. 87.2 % of the breast development was bilateral and 74.5 % of the halo enlarged were between 1.0～ 1.4 cm. About 16.2 % babies surveyed took the nourishing complements after birth. Fitting the Logistic regression model showed that taking the nutriment by the girls was the main factor in influencing the early breast development (OR= 4.38, 95 % confidence interval 2.41,7.96). Couples with a lower monthly income or who had never adopted any eugenic methods while conceiving would also be more prone to have girls with early enlarged breasts(OR=2.52, 95 % 1.26,5.02 for the former and OR=2.17,95 % 1.11,4.23 for the later).Conclusions The prevalence of premature breast development for this cohort of girls was 15.15 ‰(52/3432). Apart from the factor of nutriment intake early by the babies ,social economic condition and the general health condition of the mothers would also influence their girls'early breast development, which should be improved to protect the baby girls from premature breast development.