基于广义估计方程的婴儿超重的影响因素分析

A Study about the Influence Factors of Infant Overweight Based on Generalized Estimating Equation

目的探讨广义估计方程在婴儿超重影响因素研究中的应用,为婴幼儿保健提供科学指导。方法选取长沙市开福区2013年全年内出生的575例婴儿,回顾性收集婴儿0、1、3、6、8、12月龄的身长及体重。以婴儿是否超重为因变量,婴儿超重可能的影响因素为自变量,用SPSS19.0构建广义估计方程,筛选出婴儿超重的影响因素。结果婴儿高出生体重（OR=5.080,P=0.000）、母亲孕前高BMI值（OR=1.064,P=0.002）、男性婴儿（OR=1.547,P=0.002）及孕期体重增长过高（OR=11.058,P=0.007）均是0～12月龄婴儿超重的危险因素,孕期进行体育锻炼（OR=0.605,P=0.002）、早孕反应（OR=0.925,P=0.007）及4月龄内纯母乳喂养（OR=0.516,P=0.018）是婴儿超重的保护因素。结论针对上述影响因素,在客观因素不能改变的情况下,提倡孕妇孕前即保持正常体重,孕期注意运动、控制体重过快增长,减少巨大儿的发生率,尽可能纯母乳喂养,采取有针对性的干预措施从多方面控制婴儿超重的发生。

Objective To explore the application of generalized estimating equation in infant overweight study, to provide scientific guidance for infant health care. Methods To select 575 infants who was born from January 1, 2013 to December31, 2013 in Changsha KAIFU by cluster sampling, and establish a retrospective birth cohort, collected baby＇s length and weight of zero,f irst, third, sixth, eighth, and twelfth months. Overweight or not was the dependent variable, and independent variables were infant overweight influencing factors,SPSS19. 0 was used to build the generalized estimating equation. Results High birth weight（ OR = 5. 080,P = 0. 000）,high pre-pregnancy BMI（ OR = 1. 064,P = 0. 002）,male infant（ OR = 1. 547,P = 0. 002） and excessive weight gain during pregnancy（ OR = 11. 058,P = 0. 007） were the risk factors of infants overweight; exercise during pregnancy（ OR = 0. 605,P = 0. 002）,vomiting during pregnancy（ OR = 0. 925,P = 0. 007） and exclusive breastfeeding within 4months（ OR = 0. 516,P = 0. 018） were the protective factors of infant overweight. Conclusion Under the condition of objective factors cannot be changed, taking targeted prevention measures for the influence factors of overweight, advocate pregnant woman to do exercise before and during pregnancy positively, control excessive weight growth, as far as possible to give exclusive breastfeeding,to control infants overweight in many ways.