Yoshida Aya, Kaneko Kayo, Aoyama Kohei, Yamaguchi Naoya, Suzuki Atsushi, Kato Sayaka, Ebara Takeshi, Sugiura-Ogasawara Mayumi, Kamijima Michihiro, Saitoh Shinji
Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University, Nagoya 4670001, Japan.
Department of Occupational and Environmental Health, Graduate School of Medical Sciences, Nagoya City University, Nagoya 4670001, Japan.
Children (Basel). 2023 Mar 15;10(3):557. doi: 10.3390/children10030557.
Later-borns tend to be shorter than first-borns in childhood and adulthood. However, large-scale prospective studies examining growth during infancy according to birth order are limited. We aimed to investigate the relationship between birth order and growth during the first 4 years of life in a Japanese prospective birth cohort study. A total of 26,249 full-term singleton births were targeted. General linear and multivariable logistic regression models were performed and adjusted for birth weight, parents' heights, maternal age at delivery, gestational weight gain, maternal smoking and alcohol drinking status during pregnancy, household income, breastfeeding status, and Study Areas. The multivariate adjusted mean length Z-scores in "first-borns having no sibling", "first-borns having siblings", "second-borns", and "third-borns or more" were -0.026, -0.013, 0.136, and 0.120 at birth and -0.324, -0.330, -0.466, and -0.569 at 10 months, respectively. Results similar to those at 10 months were observed at 1.5, 3, and 4 years. The adjusted odds ratios (95% confidence intervals) of short stature at 4 years in "first-borns having siblings", "second-borns", and "third-borns or more" were 1.08 (0.84-1.39), 1.36 (1.13-1.62), and 1.50 (1.20-1.88), respectively, versus "first-borns having no sibling". Birth order was significantly associated with postnatal growth and may be a factor predisposing to short stature in early childhood.
在儿童期和成年期，后出生的孩子往往比头胎出生的孩子个子矮。然而，根据出生顺序对婴儿期生长情况进行的大规模前瞻性研究有限。我们旨在通过一项日本前瞻性出生队列研究，调查出生顺序与生命最初4年生长之间的关系。总共纳入了26249例足月单胎出生的婴儿。采用一般线性模型和多变量逻辑回归模型，并对出生体重、父母身高、母亲分娩时年龄、孕期体重增加、母亲孕期吸烟和饮酒状况、家庭收入、母乳喂养状况以及研究地区进行了校正。“无兄弟姐妹的头胎”“有兄弟姐妹的头胎”“二胎”以及“三胎及以上”在出生时的多变量校正平均身长Z评分分别为-0.026、-0.013、0.136和0.120，在10个月时分别为-0.324、-0.330、-0.466和-0.569。在1.5岁、3岁和4岁时观察到了与10个月时相似的结果。与“无兄弟姐妹的头胎”相比，“有兄弟姐妹的头胎”“二胎”以及“三胎及以上”在4岁时身材矮小的校正比值比（95%置信区间）分别为1.08（0.84 - 1.39）、1.36（1.13 - 1.62）和1.50（1.20 - 1.88）。出生顺序与出生后生长显著相关，可能是幼儿期身材矮小的一个易感因素。
