Soltani Parvaneh Reza, Ghanbari Atefeh, Rad Afagh Hasanzadeh
Ph.D Candidate, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran ; Department of Midwifery, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
Iran J Nurs Midwifery Res. 2013 May;18(3):175-9.
Overweight and obesity is becoming an increasingly prevalent problem in both developed and developing world, and is one of the most serious public health challenges of the 21(st) century. Although various studies demonstrated pediatric obesity-related factors, but, due to its ongoing hazardous effects, researchers aimed to assess obesity-related factors in school-aged children in Rasht, Iran.
This was a case-control study which was performed in eight primary schools of Rasht. A cluster sampling method was used to select 320 students including 80 in case (BMI ≥85(th) percentile for age and gender) and 240 in control group (BMI = 5(th)-85(th) percentile for age and gender). Data were collected by a scale, a tape meter, and a form which consisted of obesity-related factors, and were analyzed by Chi-square, Mann-Whitney, and stepwise multivariate regression tests in SPSS 19.
Findings showed that the mean and standard deviation of birth weight (g) in case and control groups were 3671 ± 5.64 and 190 ± 5.46, respectively (P = 0.000). 82.5% of case and 92.9% of control group had exclusive breastfeeding for 4-6 months (P = 0.024). Also, multivariate regression analysis indicated that birth weight, age, exclusive breastfeeding, and frequency of meals have significant effects on body mass index (BMI).
It seems that more accurate interventions for primordial prevention are essential to reduce childhood obesity risk factors, including promotion of pre-pregnancy and prenatal care to have neonates who are appropriate for gestational age and also improving exclusive breastfeeding in the first 6 months of life. In addition, identifying children at risk for adolescent obesity provides physicians and midwives with an opportunity for earlier intervention with the goal of limiting the progression of abnormal weight gain.
超重和肥胖在发达国家和发展中国家正成为一个日益普遍的问题，并且是21世纪最严峻的公共卫生挑战之一。尽管各项研究表明了与儿童肥胖相关的因素，但是，鉴于其持续的有害影响，研究人员旨在评估伊朗拉什特学龄儿童中与肥胖相关的因素。
这是一项在拉什特的八所小学开展的病例对照研究。采用整群抽样方法选取320名学生，其中80名属于病例组（按年龄和性别计算BMI≥第85百分位数），240名属于对照组（按年龄和性别计算BMI=第5-85百分位数）。通过体重秤、卷尺以及一份包含与肥胖相关因素的表格收集数据，并在SPSS 19中采用卡方检验、曼-惠特尼检验和逐步多元回归检验进行分析。
研究结果显示，病例组和对照组出生体重（克）的均值及标准差分别为3671±5.64和190±5.46（P=0.000）。病例组的82.5%和对照组的92.9%曾纯母乳喂养4-6个月（P=0.024）。此外，多元回归分析表明，出生体重、年龄、纯母乳喂养以及进餐频率对体重指数（BMI）有显著影响。
似乎对于一级预防采取更精准的干预措施对于降低儿童肥胖风险因素至关重要，包括加强孕前和产前保健以生出适于胎龄的新生儿，以及改善出生后头6个月的纯母乳喂养情况。此外，识别有青少年肥胖风险的儿童为医生和助产士提供了进行早期干预的机会，目的是限制异常体重增加的进展。
