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巨大儿的危险因素及长期健康后果:中国江苏省的一项前瞻性研究

Risk factors and long-term health consequences of macrosomia: a prospective study in Jiangsu Province, China.

作者信息

Gu Shouyong, An Xiaofei, Fang Liang, Zhang Xiaomin, Zhang Chunyan, Wang Jingling, Liu Qilan, Zhang Yanfang, Wei Yongyue, Hu Zhibin, Chen Feng, Shen Hongbing

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 210029, China;

出版信息

J Biomed Res. 2012 Jul;26(4):235-40. doi: 10.7555/JBR.26.20120037. Epub 2012 Jul 6.

Abstract

We sought to determine risk factors associated with fetal macrosomia and to explore the long-term consequence of infant macrosomia at the age of 7 years. A prospective population based cohort study was designed to examine the associations between maternal and perinatal characteristics and the risk of macrosomia. A nested case-control study was conducted to explore the long-term health consequence of infant macrosomia. The mean maternal age of the macrosomia group was 24.74±3.32 years, which is slightly older than that in the control group (24.35±3.14 years, P = 0.000). The mean maternal body mass index (BMI) at early pregnancy was 22.75±2.81 kg/m(2), which was also higher than that in the control group (21.76±2.59 kg/m(2), P = 0.000). About 64.6% of macrosomic neonates were males, compared with 51.0% in the control group (P = 0.000). Compared with women with normal weight (BMI: 18.5-23.9 kg/m(2)), women who were overweight (BMI: 24-27.9 kg/m(2)) or obese (BMI≥28 kg/m(2)), respectively, had a 1.69-fold (P = 0.000) and a 1.49-fold (P = 0.000) increased risks of having a neonate with macrosomia, while light weight (BMI<18.5 kg/m(2)) women had an approximately 50% reduction of the risk. Furthermore, macrosomia infant had a 1.52-fold and 1.50-fold risk, respectively, of developing overweight or obesity at the age of 7 years (P = 0.001 and P = 0.000). Older maternal age, higher maternal BMI at early pregnancy and male gender were independent risk factors of macrosomia. Macrosomic infant was associated with an increased predisposition to develop overweight or obesity at the beginning of their childhood.

摘要

我们试图确定与巨大儿相关的风险因素,并探讨婴儿期巨大儿在7岁时的长期后果。设计了一项基于人群的前瞻性队列研究,以检验母亲和围产期特征与巨大儿风险之间的关联。进行了一项巢式病例对照研究,以探讨婴儿期巨大儿的长期健康后果。巨大儿组母亲的平均年龄为24.74±3.32岁,略高于对照组(24.35±3.14岁,P = 0.000)。孕早期母亲的平均体重指数(BMI)为22.75±2.81kg/m²,也高于对照组(21.76±2.59kg/m²,P = 0.000)。约64.6%的巨大儿新生儿为男性,而对照组为51.0%(P = 0.000)。与体重正常(BMI:18.5 - 23.9kg/m²)的女性相比,超重(BMI:24 - 27.9kg/m²)或肥胖(BMI≥28kg/m²)的女性生出巨大儿新生儿的风险分别增加了1.69倍(P = 0.000)和1.49倍(P = 0.000),而体重过轻(BMI<18.5kg/m²)的女性风险降低了约50%。此外,巨大儿在7岁时患超重或肥胖的风险分别为1.52倍和1.50倍(P = 0.001和P = 0.000)。母亲年龄较大、孕早期母亲BMI较高和男性性别是巨大儿的独立风险因素。巨大儿婴儿在童年早期患超重或肥胖的易感性增加。

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