孕妇孕期增重对婴儿体格发育影响的队列研究

Effects of gestational weight gain on infant physical development:a cohort study

目的研究孕妇孕期增重(GWG)对0~1岁婴儿体质量、身长和脐带血瘦素水平的影响,探讨瘦素在孕妇营养对婴儿体格发育影响中的调控作用。方法选取2019年9月至2020年9月于中国医科大学附属第四医院住院分娩的464对母子对作为研究对象,并通过问卷调查、分娩记录、随访和主要结果测量,收集孕妇、新生儿和婴儿6月龄及1岁时的信息。采用多重线性回归分析孕妇GWG对0~1岁婴儿体格发育的影响,采用Pearson相关性分析探讨出生体质量与6月龄及1岁婴儿体质量的关系,采用Spearman相关性分析探讨瘦素的作用。结果孕妇GWG不足和过多的检出率分别为6.3%和70.9%。孕妇GWG过多会导致新生儿出生体质量(β=0.199,95%CI:0.118~0.280,P<0.001)和出生身长(β=0.441,95%CI:0.111~0.771,P<0.05)显著增高,孕妇GWG对6月龄及1岁婴儿的体质量和身长均无显著影响(P>0.05),但新生儿出生体质量与6月龄及1岁婴儿体质量呈正相关(r=0.341,P<0.001和r=0.297,P<0.001)。脐带血瘦素水平与孕妇GWG和新生儿出生体质量均呈正相关(r=0.255,P=0.028和r=0.434,P<0.001)。结论沈阳市孕妇GWG过多的现象严重,瘦素可能在孕妇GWG过多导致新生儿出生体质量增加中发挥调控作用。

Objective To study the effects of pregnant women’s gestational weight gain(GWG)on the weight and length of 0-to 1-year-old infants and the level of leptin in cord blood,and to investigate the regulatory role of leptin in the effects of pregnant women’s nutrition on infant physical development.Methods A total of 464 mother-child pairs hospitalized and delivered in a third-class hospital in The Fourth Hospital of China Medical University were selected as the study participants from September,2019 to September,2020.Information on pregnant women,newborns,and infants at 6 months and 1 year was collected through questionnaire survey,delivery records,follow-up,and measurement of main results.The effect of pregnant women’s GWG on the physical development of 0-to 1-year-old infants was analyzed using multiple linear regression analysis.The relationship between birth weight and the weight of 6-month-and 1-year-old infants was investigated using the Pearson correlation analysis.The role of leptin was investigated using the Spearman correlation analysis.Results The detection rate of insufficient and excessive GWG was 6.3%and 70.9%,respectively.Excessive GWG in pregnant women can significantly increase birth weight(β=0.199,95%CI:0.118-0.280,P<0.001)and length(β=0.441,95%CI:0.111-0.771,P<0.05)in newborns.The pregnant women’s GWG had no significant effect on the weight and length of 6-month-and 1-year-old infants(P>0.05);however,neonatal birth weight was positively correlated with the weight of 6-month-and 1-year-old infants(r=0.341,P<0.001 and r=0.297,P<0.001).Cord blood leptin concentrations were positively correlated with pregnant women’s GWG and neonatal birth weight(r=0.255,P=0.028 and r=0.434,P<0.001).Conclusion A serious phenomenon of excessive GWG was observed among pregnant women in Shenyang,and leptin may play a regulatory role in neonatal birth weight gain caused by excessive maternal GWG.