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不同生后生长模式的足月、巨大儿婴儿的儿童期健康结局。

Childhood Health Outcomes in Term, Large-for-Gestational-Age Babies With Different Postnatal Growth Patterns.

机构信息

Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.

Department of Neonatology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People's Republic of China.

出版信息

Am J Epidemiol. 2018 Mar 1;187(3):507-514. doi: 10.1093/aje/kwx271.

Abstract

Large-for-gestational-age (LGA) babies have a higher risk of metabolic disease later in life, and their postnatal growth in early childhood may be associated with long-term adverse outcomes. This study aimed to determine childhood health outcomes of term LGA babies with different growth patterns. Data were obtained from the US Collaborative Perinatal Project for the years between 1959 and 1976. The growth trajectories of 3,316 term LGA babies were identified and odds ratios of obesity, growth restriction, low intelligence quotient (IQ), and high blood pressure (HBP) were calculated by logistic regression. Compared with term appropriate-for-gestational-age infants, term LGA babies without catch-down growth had increased risks of obesity (adjusted odds ratio (aOR) = 6.37, 95% confidence interval (CI): 5.24, 7.73) and HBP (aOR = 1.67, 95% CI: 1.37, 2.03). Those with high catch-down growth had higher risks of growth restriction (aOR = 2.21, 95% CI: 1.66, 2.95) and low IQ (aOR = 1.61, 95% CI: 1.04, 2.49). Nevertheless, infants with small catch-down growth had lower risks of obesity (aOR = 0.78, 95% CI: 0.63, 0.95), growth restriction (aOR = 0.28, 95% CI: 0.17, 0.46), low IQ (aOR = 0.66, 95% CI: 0.41, 1.06), and HBP (aOR = 0.89, 95% CI: 0.77, 1.04). According to our data, term LGA infants with small catch-down growth had no increased risks of adverse outcomes.

摘要

巨大儿(LGA)在以后的生活中患代谢疾病的风险较高,他们在幼儿期的生长速度可能与长期不良结局有关。本研究旨在确定不同生长模式下足月 LGA 婴儿的儿童健康结局。数据来自美国 1959 年至 1976 年期间的合作围产期项目。确定了 3316 名足月 LGA 婴儿的生长轨迹,并通过 logistic 回归计算肥胖、生长受限、低智商(IQ)和高血压(HBP)的优势比。与足月适于胎龄的婴儿相比,没有追赶生长的足月 LGA 婴儿肥胖的风险增加(调整优势比(aOR)=6.37,95%置信区间(CI):5.24,7.73)和 HBP(aOR=1.67,95%CI:1.37,2.03)。那些高追赶生长的婴儿生长受限(aOR=2.21,95%CI:1.66,2.95)和低 IQ(aOR=1.61,95%CI:1.04,2.49)的风险更高。然而,追赶生长较小的婴儿肥胖的风险较低(aOR=0.78,95%CI:0.63,0.95),生长受限(aOR=0.28,95%CI:0.17,0.46),低 IQ(aOR=0.66,95%CI:0.41,1.06)和 HBP(aOR=0.89,95%CI:0.77,1.04)。根据我们的数据,追赶生长较小的足月 LGA 婴儿没有增加不良结局的风险。

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