摘要
目的描述婴幼儿BMI生长轨迹,探讨母乳喂养对婴幼儿BMI生长轨迹的影响。方法采用前瞻性队列研究设计,对符合纳入条件的1 388名新生儿进行随访,于42 d、3个月、6个月、9个月、12个月、18个月和24个月对婴幼儿进行体格测量,同时收集喂养、户外活动、患病等信息。运用潜变量增长模型拟合0~2岁BMI生长轨迹,采用多水平Logistic回归模型分析母乳喂养对不同BMI生长轨迹的影响。结果纳入分析的1 285名婴幼儿的BMI生长轨迹主要划分为6类:"正常平稳"(26.6%)、"正常-加速"(8.7%)、"正常-减缓"(11.7%)、"持续偏低"(6.6%)、"赶上生长"(26.8%)和"赶上生长-加速"(19.5%)。以"正常平稳"组作为参考,多水平Logistic回归模型显示:至少纯母乳喂养3个月可显著降低"赶上生长"(OR=0.71, 95%CI 0.51~0.98)和"赶上生长-加速"(OR=0.53,95%CI 0.37~0.75)模式发生的危险;调整混杂因素后,此关系仍然成立(OR=0.61,95%CI 0.41~0.89;OR=0.46,95%CI 0.31~0.68)。半岁前断母乳可显著增加"赶上生长"(OR=1.76,95%CI 1.19~2.61)和"赶上生长-加速"(OR=2.08,95%CI 1.38~3.14)模式发生的危险;调整混杂因素后,此关系仍然成立(OR=1.69, 95%CI 1.08~2.71;OR=1.88,95%CI 1.18~2.99)。结论中国西部农村地区婴幼儿BMI生长轨迹以"正常平稳"、"赶上生长"和"赶上生长-加速"3种模式为主;母乳喂养可降低婴幼儿追赶生长发生的危险。
Objective To describe the BMI growth trajectories from birth to 24 months and examine the effects of fully breastfeeding time and breastfeeding duration on the BMI growth trajectories. Methods We conducted a follow-up study of a cohort of 1 388 eligible births. Height and weight were measured at birth, every 3 months to 12 months, and every 6 months to 24 months. Detailed demographic, feeding, activity and diseases data were also collected prospectively. Latent growth mixture modeling was conducted to model the BMI growth trajectories from birth to 24 months. Mixed-effects logistic regression analyses were made to examine the impacts of breastfeeding on this outcome. Results We identified six BMI trajectory patterns in the 1 285 infants analyzed and labeled them as follows: "normative growth"(26.6%), "normal-accelerating growth"(8.7%), "normal-decelerating growth"(11.7%),"lower-persistent growth"(6.6%),"rapid growth"(26.8%),and "rapid-accelerating growth"(19.5%).Mixed-effects logistic regression analyses revealed that fully breastfeeding ≥ 3 months could significantly decrease the risk of"rapid growth"(OR=0.71,95% CI 0.51-0.98)and"rapid-accelerating growth"(OR=0.53,95% CI 0.37-0.75).After adjustment for confounding factors,the relationship remained significant(OR=0.61,95% CI 0.41-0.89;OR=0.46,95% CI 0.31-0.68).Weaning before 6 months could significantly increase the risk of"rapid growth"(OR=1.76,95% CI 1.19-2.61)and"rapid-accelerating growth"(OR=2.08,95% CI 1.38-3.14).These associations persisted after adjustment for confounding factors(OR=1.69,95% CI 1.08-2.71;OR=1.88,95% CI 1.18-2.99).Conclusion In rural Western China,the main BMI growth trajectory patterns include"normative growth","rapid growth",and "rapid-accelerating growth".Prolonging breastfeeding may reduce excess weight gain during infancy.
作者
周静
曾令霞
米白冰
康轶君
王莉
王晔
颜虹
肖延风
ZHOU Jing;ZENG Lingxia;MI Baibing;KANG Yijun;WANG Li;WANG Ye;YAN Hong;XIAO Yanfeng(Department of Pediatrics,The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004;Department of Epidemiology and Biostatistics,School of Public Health of Xi’an Jiaotong University Health Science Center,Xi’an 710061;Department of Traditional Chinese Medicine,The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China)
出处
《西安交通大学学报（医学版）》
CAS
CSCD
北大核心
2021年第2期317-322,共6页
Journal of Xi’an Jiaotong University（Medical Sciences）
基金
陕西省自然科学基础研究计划资助项目(No.2020JM-077,No.2020JQ-547)。
