Children's Hospital Boston, Division of Newborn Medicine, Hunnewell 437, 300 Longwood Ave, Boston, MA 02115, USA.
Pediatrics. 2010 Jun;125(6):e1419-26. doi: 10.1542/peds.2009-2746. Epub 2010 May 17.
More rapid infant weight gain may be associated with better neurodevelopment but also with higher blood pressure (BP). The objective of this study was to determine the extent to which infant weight gain is associated with systolic BP (SBP) and IQ at school age in former preterm, low birth weight infants.
We studied 911 participants in the Infant Health and Development Program, an 8-center longitudinal study of children born at < or = 37 weeks' gestation and < or = 2500 g. Study staff weighed participants at term and at 4 and 12 months' corrected ages; measured BP 3 times at 6.5 years; and administered the Wechsler Intelligence Scale for Children, Third Edition (WISC-III), an IQ test, at 8 years. In linear regression, we modeled our exposure "infant weight gain" as the 12-month weight z score adjusted for the term weight z score.
Median (interquartile range) weight z score was -0.7 (-1.5 to -0.0) at 12 months. Mean + or - SD SBP at 6.5 years was 104.2 + or - 8.4 mmHg, and mean + or - SD WISC-III total score at 8 years was 91 + or - 18. Adjusting for child gender, age, and race and maternal education, income, age, IQ, and smoking, for each z score additional weight gain from term to 12 months, SBP was 0.7 mmHg higher and WISC-III total score was 1.9 points higher.
In preterm infants, there seem to be modest neurodevelopmental advantages of more rapid weight gain in the first year of life and only small BP-related effects.
婴儿体重增长较快可能与更好的神经发育有关，但也可能与更高的血压（BP）有关。本研究的目的是确定早产儿、低出生体重儿在生命的第一年体重增加与收缩压（SBP）和学龄期智商（IQ）的关联程度。
我们研究了婴儿健康与发育计划（Infant Health and Development Program）中的 911 名参与者，这是一项针对妊娠 37 周及以下和/或出生体重 2500 克及以下的儿童的 8 中心纵向研究。研究人员在足月时以及校正年龄的 4 个月和 12 个月时对参与者进行称重；在 6.5 岁时测量了 3 次血压；并在 8 岁时进行了韦氏儿童智力量表，第三版（WISC-III），一项智商测试。在线性回归中，我们将“婴儿体重增加”的暴露情况建模为 12 个月体重 z 分数减去足月体重 z 分数。
12 个月时的体重 z 分数中位数（四分位数范围）为-0.7（-1.5 至-0.0）。6.5 岁时的平均+或-SD SBP 为 104.2+或-SD 8.4mmHg，8 岁时的平均+或-SD WISC-III 总分为 91+或-SD 18。在调整了儿童性别、年龄、种族以及母亲教育、收入、年龄、智商和吸烟情况后，每增加一个 z 分数的体重从足月到 12 个月，SBP 升高 0.7mmHg，WISC-III 总分升高 1.9 分。
在早产儿中，生命第一年体重增长较快似乎具有适度的神经发育优势，而与血压相关的影响较小。
