河北五县婴儿不同时期体格发育状况分析

Analysis of infants' growth at different months in 5 counties of Hebei province

目的探讨和评价河北省五个县(香河、丰润、乐亭、满城和元氏)婴儿体格发育状况。方法本研究基于北京大学生育健康研究所于2006年5月至2009年4月在河北省五个县开展的"孕期营养项目",该项目将18 775例孕产妇随机分为三组,分别给予叶酸、铁和叶酸复合制剂以及复合微量营养素(含叶酸和铁)的干预,并于子代3、6、9、12月龄随访检查。本研究对男女婴儿不同时期的体重、身长和头围等进行描述分析,以世界卫生组织2006年儿童生长发育标准(以下简称"WHO标准")计算男女婴儿不同时期的Z评分以及低体重率、生长迟缓率、消瘦率、超重率和肥胖率。结果共17 605例婴儿纳入研究,其中男婴9 240例(52.5%),女婴8 365例(47.5%)。婴儿整体体格发育水平高于WHO标准,各项体格发育指标在出生到3月龄时期增速最快。男婴不同时期的体重、身长和头围高于女婴,但男婴不同时期的年龄别体重Z评分、年龄别身长Z评分、身长别体重Z评分和BMI Z评分均低于女婴,以上差异均有统计学意义。婴儿低体重率、生长迟缓率和消瘦率分别在0~1.8%,0.3%~1.8%,0.2%~1.6%的区间范围,且随月龄增加而降低(趋势检验P<0.05);男婴低体重、生长迟缓和消瘦的发生风险高于女婴,差异有统计学意义;婴儿超重率和肥胖率分别在2.5%~7.7%,0.5%~1.3%的区间,并随月龄增加而增大(趋势检验P<0.05),其中9到12月龄增速最快。超重率和肥胖率的性别差异不明显。结论河北省五个县的婴儿体格发育水平总体较好,女婴体格发育水平高于男婴,但须注意婴儿期超重率和肥胖率过快增长,必要时及时采取干预措施。

Objective To evaluate physical development and growth of infants in 5 counties （Xianghe, Fengrun, Laoting, Mancheng and Yuanshi） of Hebei province.MethodsData were from Nutrition Project on Pregnant Women conducted by the Institute of Reproductive and Child Heath of Peking University from May 2006 to April 2009.18 775 pregnant women were randomly assigned to daily folic acid, folic acid-iron, multiple micronutrients （including iron and folic acid）.Their offspring were followed up in 3th, 6th, 9th ,12th months after birth.Based on the description of weight, height, head circumference of male and female infants in different months, Z scores and rates of underweight, stunting, wasting, overweight and obesity were calculated according to WHO child growth standards （2006）.ResultsA total of 17605 infants, 9240 males （52.5%） and 8 365 females（47.5%）, were included in the study.Overall, infants＇＇ growth was above median according to WHO standards at their ages.All indicators of growth increased rapidly from birth to 3 months.Although male infants had higher weights, heights and head circumferences than female infants＇＇ in different months （P〈0.05）, WAZ, LAZ, WLZ and BMIZ of male were lower than females （P〈0.05）.The rates of the infants＇＇ underweight, stunting and wasting were in the intervals of 0~1.8%,0.3~1.8 and 0.2~1.6, respectively, and decreased with age （P〈0.05）, and the rates of the infants＇＇ overweight and obesity were in the intervals of 2.5~7.7%, 0.5~1.3%, respectively, and increasing with age（P〈0.05）, especially between 9th and 12th months.The rates of male infants＇＇ underweight, stunting and wasting were higher than female infants＇＇ （P〈0.05）, while there was no significant differences of overweight and obesity between male and female infants.ConclusionOverall, infants＇＇ physical growth in 5 counties of Hebei province was good, and physical growth of female was better than male.Increasing of overweight and obesity among infants should be paid more attention, and measures should be taken if necessary.