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影响幼儿生长轨迹的孕产妇体重指数、母乳喂养及围产期因素:一项范围综述

Maternal BMI, breastfeeding and perinatal factors that influence early childhood growth trajectories: a scoping review.

作者信息

Abrego Del Castillo Kayla Y, Dennis Cindy-Lee, Wamithi Susan, Briollais Laurent, McGowan Patrick O, Dol Justine, Lye Stephen J

机构信息

Department of Physiology, University of Toronto, Toronto, Ontario, Canada.

Lunenfeld Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada.

出版信息

J Dev Orig Health Dis. 2022 Oct;13(5):541-549. doi: 10.1017/S2040174421000726. Epub 2022 Jan 6.

Abstract

Obesity rates among children are rapidly rising internationally and have been linked to noncommunicable diseases in adulthood. Individual preventive strategies have not effectively reduced global obesity rates, leading to a gap in clinical services regarding the development of early perinatal interventions. The objective of this scoping review is to explore the relationship between maternal BMI and breastfeeding behaviors on child growth trajectories to determine their relevance in developing interventions aimed at preventing childhood obesity.The scoping review was guided and informed by the Arksey and O'Malley (2005) framework. A systematic search was performed in four databases. Studies included in the final review were collated and sorted into relevant themes. A systematic search yielded a total of 5831 records (MEDLINE: 1242, EMBASE: 2629, CINAHL: 820, PubMed: 1140). Results without duplicates (n = 4190) were screened based on relevancy of which 197 relevant-full-text articles were retrieved and assessed for eligibility resulting in 14 studies meeting the inclusion criteria. Data were extracted and charted for the studies and six themes were identified: (1) healthy behaviors, lifestyle, and social economic status; (2) parental anthropometrics and perinatal weight status; (3) genetics, epigenetics, and fetal programming; (4) early infant feeding; (5) infant growth trajectories; and (6) targeted prevention and interventions. Early life risk factors for child obesity are multifactorial and potentially modifiable. Several at-risk groups were identified who would benefit from early preventative interventions targeting the importance of healthy weight gain, exclusive breastfeeding to 6 months, and healthy lifestyle behaviors.

摘要

国际上儿童肥胖率正在迅速上升,并且与成年期的非传染性疾病有关。个体预防策略未能有效降低全球肥胖率,导致在早期围产期干预措施发展方面的临床服务存在差距。本范围综述的目的是探讨母亲体重指数与母乳喂养行为对儿童生长轨迹的关系,以确定它们在制定预防儿童肥胖的干预措施中的相关性。本范围综述以阿克西和奥马利(2005年)的框架为指导并受其启发。在四个数据库中进行了系统检索。纳入最终综述的研究进行了整理并分类为相关主题。系统检索共产生5831条记录(医学索引数据库:1242条,荷兰医学文摘数据库:2629条,护理学与健康领域数据库:820条,医学期刊数据库:1140条)。基于相关性对无重复的结果(n = 4190)进行筛选,检索出197篇相关全文文章并评估其是否符合纳入标准,最终有14项研究符合纳入标准。对这些研究的数据进行了提取和图表绘制,并确定了六个主题:(1)健康行为、生活方式和社会经济地位;(2)父母人体测量学和围产期体重状况;(3)遗传学、表观遗传学和胎儿编程;(4)早期婴儿喂养;(5)婴儿生长轨迹;(6)有针对性的预防和干预措施。儿童肥胖的早期生活危险因素是多因素的,并且可能是可改变的。确定了几个高危群体,他们将从针对健康体重增加的重要性、纯母乳喂养至6个月以及健康生活方式行为的早期预防性干预措施中受益。

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