2~6岁儿童出生情况及父母体质量指数对其体型匀称度的影响因素分析

Analysis of influencing factors of birth conditions and parental body mass index on the body shape symmetry in children aged 2-6

目的了解2~6岁儿童消瘦、超重和肥胖的流行状况,分析出生情况及父母体质量指数(BMI)对其体型匀称度的影响,为制定早期干预措施提供依据。方法采用真实世界研究方法,以2020年至2022年于上海市儿童医院儿童保健科常规健康体检的4962名2~6岁儿童为研究对象。利用儿童生长发育智能评估系统中的横断面数据构建数值表进行回顾性研究,分析不同体型匀称度的流行情况及其与出生情况、父母BMI的关联,影响因素分析采用多因素Logistic回归分析。结果调查的4962名儿童中,男童2986名(60.2%),女童1976名(39.8%),儿童消瘦、超重、肥胖总检出率分别为3.5%、7.2%、5.4%;出生体重>4000g的儿童超重肥胖检出率均高于正常出生体重组,其OR值及95%CI分别为2.337(1.458~3.747)、2.875(1.754~4.715);出生体重<2500g的儿童发生消瘦的风险增加,其OR值及95%CI为1.718(1.117~2.642);与适于胎龄儿相比,小于胎龄儿消瘦的风险增加,超重的风险降低,其OR值及95%CI分别为2.015(1.391~2.920)、0.605(0.403~0.907);大于胎龄儿发生超重、肥胖的风险均增加,其OR值及95%CI分别为1.599(1.111~2.300)、2.792(1.976~3.947);父亲超重肥胖、母亲肥胖的儿童发生超重肥胖的风险均增加(其OR值介于1.439~4.466之间,P<0.05),母亲超重的儿童发生肥胖的风险也增加,其OR值及95%CI为1.848(1.358~2.516);多因素Logistic回归分析结果显示,儿童出生体重与胎龄关系偏大及父母BMI增加是儿童期发生肥胖的危险因素,父母BMI增加也是儿童期发生超重的危险因素(其OR值介于1.742~3.927之间,P<0.05)。结论2~6岁儿童消瘦、超重、肥胖检出率较高,父母超重肥胖是儿童超重肥胖发生的危险因素,出生体重及其相较出生胎龄的关系可作为儿童异常体型匀称度的预警,社会各方应重视儿童体格发育,相关疾病的预防应尽早开始。

Objective To understand the prevalence of emaciation,overweight,and obesity among children aged 2-6,analyze the influence of birth conditions and parental body mass index(BMI)on their body shape symmetry,and provide a foundation for the development of early intervention measures.Methods Using a real-world study method,a total of 4962 children aged 2-6 who underwent routine health examinations at the department of child health care,Shanghai children s hospital from 2020 to 2022 were included in the study.Retrospective research was conducted by constructing numerical tables using cross-sectional data from the Children s Growth and Development Intelligent Assessment System.The study analyzed the prevalence of various body symmetry types and their correlation with birth conditions and parental BMI.Multivariate logistic regression analysis was employed to analyze influencing factors.Results Among the surveyed 4962 children,2986(60.2%)were boys and 1976(39.8%)were girls.The overall detection rates for emaciation,overweight,and obesity in children were 3.5%,7.2%and 5.4%,respectively.The detection rates for overweight and obesity were both higher in children with birth weights>4,000g compared to those with normal birth weight group,with OR and 95%CI s of 2.337(1.458-3.747)and 2.875(1.754-4.715),respectively.Children with birth weight<2500g had an increased risk of developing emaciation,with OR and 95%CI of 1.718(1.117-2.642).Compared to appropriate for gestational age(AGA)children,those born as small for gestational age(SGA)had an increased risk of emaciation and a decreased risk of overweight,with OR and 95%CI s of 2.015(1.391-2.920)and 0.605(0.403-0.907),respectively.Children born as large for gestational age(LGA)had an increased risk of overweight and obesity,with OR and 95%CI s of 1.599(1.111-2.300)and 2.792(1.976-3.947),respectively.Children with overweight or obese fathers,as well as obese mothers,had an increased risk of overweight and obesity(OR=1.439-4.466,P<0.05).Children with overweight mothers also had an increased risk of obesity,with OR and 95%CI of 1.848(1.358-2.516).Multivariate logistic regression analysis revealed that a larger relationship between children′s birth weight and gestational age,as well as an increase in parental BMI,were risk factors for childhood overweight(OR=1.742-3.927,P<0.05).Conclusion The detection rates of emaciation,overweight,and obesity are higher among children aged 2-6.Parental overweight and obesity are risk factors for childhood overweight and obesity.The relationship between birth weight and gestational age can serve as an early warning sign for abnormal body shape symmetry in children.It is important for society to pay attention to the physical development of children,and preventive measures for related diseases should start as early as possible.