足月出生体重与子代长期内分泌疾病之间的关联。
The association between birth weight at term and long-term endocrine morbidity of the offspring.
作者信息
Spiegel E, Shoham-Vardi I, Sergienko R, Landau D, Sheiner E
机构信息
a Department of Obstetrics and Gynecology , Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev , Be'er Sheva , Israel.
b Department of Public Health, Faculty of Health Sciences , Ben Gurion University of the Negev , Be'er Sheva , Israel.
出版信息
J Matern Fetal Neonatal Med. 2019 Aug;32(16):2657-2661. doi: 10.1080/14767058.2018.1443440. Epub 2018 Mar 7.
OBJECTIVE
To investigate whether small-for-gestational-age (SGA) and large-for-gestational-age (LGA) birth weight at-term poses an increased risk for long-term pediatric endocrine morbidity.
STUDY DESIGN
A retrospective population-based cohort study compared the incidence of long-term pediatric hospitalizations due to endocrine morbidity of singleton children born SGA, appropriate-for-gestational-age (AGA), and LGA at-term. A multivariate generalized estimating equation (GEE) logistic regression model analysis was used to control for confounders.
RESULTS
During the study period, 235,614 deliveries met the inclusion criteria; of which 4.7% were SGA (n = 11,062), 91% were AGA (n = 214,249), and 4.3% were LGA neonates (n = 10,303). During the follow-up period, children born SGA or LGA at-term had a significantly higher rate of long-term endocrine morbidity. Using a multivariable GEE logistic regression model, controlling for confounders, being delivered SGA or LGA at-term was found to be an independent risk factor for long-term pediatric endocrine morbidity (Adjusted OR = 1.4; 95%CI = 1.1-1.8; p = .015 and aOR = 1.4; 95%CI = 1.1-1.8; p = .005, respectively). Specifically, LGA was found an independent risk factor for overweight and obesity (aOR = 1.7; 95%CI = 1.2-2.5; p = .001), while SGA was found an independent risk factor for childhood hypothyroidism (aOR = 3.2; 95%CI = 1.8-5.8; p = .001).
CONCLUSIONS
Birth weight either SGA or LGA at-term is an independent risk factor for long-term pediatric endocrine morbidity.
目的
探讨足月小样儿（SGA）和足月大于胎龄儿（LGA）出生体重是否会增加儿童长期内分泌疾病的发病风险。
研究设计
一项基于人群的回顾性队列研究，比较了足月出生的单胎小样儿、适于胎龄儿（AGA）和大于胎龄儿因内分泌疾病导致的儿童长期住院发生率。采用多变量广义估计方程（GEE）逻辑回归模型分析来控制混杂因素。
结果
在研究期间，235,614例分娩符合纳入标准；其中4.7%为小样儿（n = 11,062），91%为适于胎龄儿（n = 214,249），4.3%为大于胎龄儿（n = 10,303）。在随访期间，足月出生的小样儿或大于胎龄儿长期内分泌疾病的发生率显著更高。使用多变量GEE逻辑回归模型控制混杂因素后，发现足月分娩小样儿或大于胎龄儿是儿童长期内分泌疾病的独立危险因素（校正比值比[OR]=1.4；95%置信区间[CI]=1.1 - 1.8；p = 0.015和校正OR = 1.4；95%CI = 1.1 - 1.8；p = 0.005）。具体而言，发现大于胎龄儿是超重和肥胖的独立危险因素（校正OR = 1.7；95%CI = 1.2 - 2.5；p = 0.001），而小样儿是儿童甲状腺功能减退症的独立危险因素（校正OR = 3.2；95%CI = 1.8 - 5.8；p = 0.001）。
结论
足月小样儿或大于胎龄儿出生体重是儿童长期内分泌疾病的独立危险因素。
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