Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USA.
J Perinatol. 2012 Feb;32(2):91-6. doi: 10.1038/jp.2011.75. Epub 2011 Jun 9.
The objective of this study was to determine the evolution of obesity status (OS) in a longitudinal cohort of low birth weight preterm (LBWPT) infants to an age of 8 years, and to determine whether rapid weight gain in the first year of life independently predicts 8-year OS.
In total, 985 infants (birth weight ≤2500 g, gestation age ≤37 weeks) were recruited from the nursery in an eight-site intervention research program and were evaluated at an age of 3, 5, 6.5 and 8 years. Weight and height were measured by standard protocol at each visit and body mass index was calculated. Obesity status is ≥95% for age and sex. Multiple logistic analyses were performed on 8-year OS with predictor variables including infant race, gender, small for gestational age status, birth weight category, neonatal health index, treatment group and first-year weight gain; maternal education and weight status before conception; and HOME Inventory.
Overall, 2.3% were OS at an age of 3 years, 6.1% at an age of 5 years, 7.7% at age 6.5 years and 8.7% at an age 8 years. OS varied by birth weight category at each visit. The infants born ≤1500 g had the lowest prevalence of OS at each age. In the logistic regression, maternal race (Hispanic) (adjusted odds ratio=2.8, confidence interval=1.2 to 6.8), maternal obese status (adjusted odds ratio 3.4, confidence interval=1.5 to 7.8) and first-year weight gain (adjusted odds ratio=2.7, confidence interval=1.9 to 3.9), significantly predicted 8-year OS.
OS is common in LBWPT infants during childhood, and prevalence varies by birth weight category. High weight gain in the first year of life is an important predictor of the development of OS in LBWPT children.
本研究旨在确定低出生体重早产儿（LBWPT）队列在 8 岁时的肥胖状态（OS）演变，并确定生命第一年的快速体重增加是否独立预测 8 岁时的 OS。
共纳入 985 名（出生体重≤2500g，胎龄≤37 周）来自 8 个地点干预研究项目的新生儿，在 3、5、6.5 和 8 岁时进行评估。每次就诊时均采用标准方案测量体重和身高，并计算体重指数。肥胖状态定义为≥同年龄和性别的 95%分位数。采用多变量逻辑分析方法，以婴儿种族、性别、小于胎龄儿状态、出生体重分类、新生儿健康指数、治疗组和第一年体重增加、母亲孕前教育和体重状况以及 HOME 库存为预测变量，对 8 岁时的 OS 进行分析。
总体而言，3 岁时 OS 发生率为 2.3%，5 岁时为 6.1%，6.5 岁时为 7.7%，8 岁时为 8.7%。各随访时的 OS 发生率因出生体重分类而异。出生体重≤1500g 的婴儿各年龄段 OS 发生率最低。在逻辑回归中，母亲种族（西班牙裔）（调整优势比=2.8，95%置信区间=1.2 至 6.8）、母亲肥胖状态（调整优势比 3.4，95%置信区间=1.5 至 7.8）和第一年体重增加（调整优势比=2.7，95%置信区间=1.9 至 3.9），显著预测 8 岁时的 OS。
LBWPT 婴儿在儿童期 OS 很常见，且其发生率因出生体重分类而异。生命第一年的高体重增加是 LBWPT 儿童 OS 发展的重要预测因素。
