Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China.
Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Nutrients. 2023 Feb 23;15(5):1125. doi: 10.3390/nu15051125.
Being born with appropriate weight-for-gestational age (AGA, ~80% of newborns) is often considered as low risk for future obesity. This study examined differential growth trajectories in the first two years by considering pre- and peri-natal factors among term-born AGA infants. We prospectively investigated 647 AGA infants and their mothers enrolled during 2012-2013 in Shanghai, China, and obtained repeated anthropometric measures at ages 42 days, 3, 6, 9, and 18 months from postnatal care records, and onsite measurements at age 1 and 2 years (skinfold thickness, mid-upper arm circumference (MUAC)). Birthweight was classified into sex-and gestational age-specific tertiles. Among mothers, 16.3% were overweight/obese (OWO), and 46.2% had excessive gestational weight gain (GWG). The combination of maternal prepregnancy OWO and high birthweight tertile identified a subset of AGA infants with 4.1 mm higher skinfold thickness (95% CI 2.2-5.9), 1.3 cm higher MUAC (0.8-1.7), and 0.89 units higher weight-for-length z-score (0.54, 1.24) at 2 years of age with adjustment for covariates. Excessive GWG was associated with higher child adiposity measures at 2 years of age. AGA infants manifested differential growth trajectories by the combination of maternal OWO and higher birthweight, suggesting that additional attention is needed for those "at increased risk" of OWO in early intervention.
出生时体重与胎龄相称（AGA，约 80%的新生儿）通常被认为未来肥胖的风险较低。本研究通过考虑足月 AGA 婴儿的产前和围产期因素，检查了前两年的差异生长轨迹。我们前瞻性地调查了 2012-2013 年期间在中国上海出生的 647 名 AGA 婴儿及其母亲，并从产后护理记录中获得了 42 天、3、6、9 和 18 个月时的重复人体测量数据，以及 1 和 2 岁时的现场测量数据（皮褶厚度、中上臂周长（MUAC））。出生体重分为性别和胎龄特异的三分位。母亲中，16.3%超重/肥胖（OWO），46.2%有过多的孕期体重增加（GWG）。母亲孕前 OWO 和高出生体重三分位数的组合确定了一组 AGA 婴儿，在 2 岁时皮褶厚度增加 4.1 毫米（95%CI 2.2-5.9）、MUAC 增加 1.3 厘米（0.8-1.7）和体重长度 z 分数增加 0.89 个单位（0.54，1.24），调整了协变量。GWG 过多与 2 岁时儿童肥胖程度更高有关。AGA 婴儿通过母亲 OWO 和更高出生体重的组合表现出不同的生长轨迹，表明在早期干预中，需要对那些“超重风险增加”的婴儿给予额外关注。
