广州市儿童生命早期因素与超重肥胖的关联

Association of early-life factors with the incidence of overweight and obesity among primary school students in Guangzhou

目的探讨广州市6~11岁儿童生命早期因素与超重肥胖之间的关系,为儿童超重肥胖的预防提供科学依据。方法基线采用分层整群随机抽样的方法,于2017年抽取广州市5所小学共5172名学生作为研究对象,进行2年的随访,最终纳入学生3315名。通过问卷调查收集学生的生命早期因素,并测量基线和随访中身高和体重等指标。采用Logistic回归分析儿童生命早期因素与超重肥胖的关系。结果广州市6~11岁儿童超重肥胖发生率为8.7%。校正混杂因素后,Logistic回归分析显示,母亲孕前消瘦的儿童超重肥胖发生风险比母亲孕前正常体重的儿童降低了46%(OR=0.54,95%CI=0.38~0.76);母亲孕期增重过多的儿童超重肥胖发生风险比孕期增重正常的儿童增加了55%(OR=1.55,95%CI=1.14~2.10);与自然分娩儿童相比,剖宫产的儿童超重肥胖发生风险增加了30%(OR=1.30,95%CI=1.00~1.68)(P值均<0.05)。结论母亲孕期增重过多和剖宫产增加儿童超重肥胖的发生风险,母亲孕前消瘦降低儿童超重肥胖的发生风险。

Objective To investigate the associations between early-life factors and the incidence of overweight and obesity and to provide a reference for childhood overweight and obesity prevention.Methods A total of 5172 children aged 6-11 years from 5 primary schools in Guangzhou were enrolled using stratified random cluster sampling method.After two-years follow up,3315 children were included in the final analysis.Questionnaire was used to collect children’s early-life factors.Height and weight were measured objectively at baseline and follow-up.Results The incidence of overweight and obesity was 8.7%in children.After adjustment for confounders,results from the Logistic regression analysis showed that maternal pre-pregnancy underweight was negatively associated with the incidence of childhood overweight and obesity(OR=0.54,95%CI=0.38-0.76)(P<0.05).While excessive gestational weight gain during pregnancy(OR=1.55,95%CI=1.14-2.10)and caesarean section(OR=1.30,95%CI=1.00-1.68)were positively associated with the incidence of childhood overweight and obesity(P<0.05).Conclusion Both excess gestational weight gain and caesarean section would increase the risk of the overweight and obesity of their offspring,while maternal pre-pregnancy underweight would reduce the risk of childhood overweight and obesity.