我国城市儿童0-2岁期间生长发育水平和体重指数Z值预测模型及轨迹研究

发布时间：2018-06-12 02:02

本文选题：婴幼儿 + 体重指数Z值　；参考：《华中科技大学》2013年硕士论文

【摘要】：目的：纵向了解目前我国城市儿童0-2岁期间的生长发育水平，建立BMI_Z值的预测模型和年龄轨迹。方法：采用多阶段分层随机抽样方法，于2009年4月1日-2010年3月31日间在沈阳、武汉和广州三城市选取符合条件的新生儿，将同意参与项目的家庭作为调查对象进行为期2年的随访，内容包括体格测量和饮食、睡眠情况问卷调查等。采用Epidata3.1建立数据库，用SAS9.1软件进行统计分析，利用混合线性模型建立BMI_Z值的预测模型和年龄轨迹。结果：（1）一般情况：共收录新生儿2220名，男女性别比为1.08:1；共随访11455人次，总随访率为73.71%。（2）体格发育水平：①男童身长、体重和体重指数显著高于同龄女童（P0.05）；②儿童体重Z值（WT_Z），身长Z值（HT_Z）和BMI_Z值曲线整体右移；③男、女童0-2岁期间高/超高BMI检出率随年龄增长逐渐升高，1岁左右达到峰值，2岁时男童超重/肥胖率显著高于女童（P＝0.0467）。（3）BMI_Z值的预测模型：通过儿童性别、父母体重状态、家庭收入与结构和3月内婴儿喂养模式等变量来对2岁内儿童BMI_Z值进行预测：①母亲孕前超重和肥胖组儿童BMI_Z值平均比正常体重组高0.30，，孕前营养不良组比正常体重组低0.17；②3月纯母乳喂养对儿童BMI_Z值影响随时间发生变化：3月龄时，纯母乳喂养儿童的BMI_Z值高于人工喂养组0.07；6月龄时两组接近，2岁时，纯母乳喂养的儿童BMI_Z值显著低于人工喂养组0.3；③父亲体重状态、胎龄、分娩方式也可影响儿童BMI_Z值。（4）BMI_Z值的年龄轨迹：母亲孕前不同体重状态对男、女童0-2岁期间原始BMI_Z值年龄轨迹均显著影响；校正协变量后，母亲孕前体重状态对男童BMI_Z值年龄轨迹影响显著，但未检出对女童BMI_Z值的作用。结论：①我国城市0-2岁儿童生长发育水平良好，并超过了WHO标准，继续呈现出生长长期趋势；②儿童生长水平提高的同时伴随着BMI_Z值曲线右移，警示儿童早期肥胖问题的出现；③父母体重状态、分娩方式、新生儿胎龄和早期喂养模式是我国城市儿童0-2岁期间BMI_Z值的重要预测因子；④母亲孕前体重状态对男童BMI_Z值年龄轨迹有显著影响。
[Abstract]:Objective: to investigate the growth and development level of urban children aged 0-2 years in China, and to establish a prediction model and age trajectory of BMIZ value. Methods: a multi-stage stratified random sampling method was used in Shenyang from April 1, 2009 to March 31, 2010. The eligible newborns were selected from Wuhan and Guangzhou, and the families who agreed to participate in the project were followed up for 2 years, including physical measurement, diet, sleep survey and so on. Epidata 3.1 was used to establish database, SAS9.1 software was used for statistical analysis, and mixed linear model was used to establish prediction model of BMIZ value and age locus. Results: 2220 newborns were collected, the sex ratio of male and female was 1.08: 1, and 11455 follow-up visits were made. The total follow-up rate was 73.71.The body length, body mass index and body mass index of boys with physical development level: 1 were significantly higher than that of girls of the same age. The prevalence rate of high / ultra-high BMI in girls aged 0-2 years increased gradually with the increase of age. The prevalence of overweight / obesity in boys was significantly higher than that in girls at the age of about 1 and 2 years. The prediction model of BMIZ value in girls was as follows: according to the sex of children, the weight status of parents, the rate of overweight / obesity in boys was significantly higher than that in girls. Family income and structure and Infant feeding pattern in three months to predict BMIZ value of Children within 2 years of age; BMIZ value of Children with overweight and Obesity before pregnancy of mothers at 1: 1 was 0.30 higher than that of normal body weight on average, and BMIZ value of Pre-Maternal malnutrition was higher than normal body The effect of exclusive breast-feeding for 23 months on the BMIZ value of children changed with time at the age of 3 months. The BMIZ value of exclusively breast-fed children was higher than that of artificial feeding group at 0.07 ~ 6 months, and the BMIZ value of exclusive breast-fed children was significantly lower than that of artificial feeding group (0.3 / 3 father body weight and gestational age). The age locus of BMIZ value in children was also affected by the delivery mode. The age locus of BMIZ value was significantly affected by the different weight status of mother before pregnancy on the age locus of original BMIZ value during 0-2 years of age of male and girl; after adjusting the covariable, The weight state of mother before pregnancy had a significant effect on the age trajectory of BMIZ value of boys, but no effect on the BMIZ value of girls. Conclusion: the growth and development level of children aged 0-2 in the cities of China is good, which is higher than WHO standard, and continues to show a long-term trend of growth. (2) the improvement of children's growth level was accompanied by the right shift of BMIZ value curve, which warned the occurrence of early obesity in children, such as parents' weight status and delivery mode. Neonatal gestational age and early feeding pattern are important predictors of BMIZ value in urban children in China. The weight state of mothers before pregnancy has a significant influence on the age trajectory of BMIZ value in boys.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R179

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