中国儿童保健杂志 ›› 2021, Vol. 29 ›› Issue (7): 717-720.DOI: 10.11852/zgetbjzz2020-1060

• 科研论著 • 上一篇    下一篇

妊娠期糖尿病与儿童超重肥胖的相关性研究

贾朝霞, 赵永鲜, 黄丽丽, 王军华, 王朝, 武明辉   

  1. 首都医科大学附属北京妇产医院群体信息科,北京 100026
  • 收稿日期:2020-06-04 修回日期:2020-08-12 出版日期:2021-07-10 发布日期:2021-07-28
  • 通讯作者: 武明辉,E-mail:wumh200711@163.com
  • 作者简介:贾朝霞(1979-),女,山东人,主治医师,博士学位,主要从事妇幼保健工作。
  • 基金资助:
    首都卫生发展科研专项资助(首发2020-2-2111);中国疾病预防控制中心妇幼保健中心“母婴营养与健康研究项目”(2019FYH001)

Correlation between gestational diabetes mellitus exposure and offspring obesity

JIA Zhao-xia, ZHAO Yong-xian, HUANG Li-li, WANG Jun-hua, WANG Zhao, WU Ming-hui   

  1. Department of Information and Statistics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University,Beijing 100026, China
  • Received:2020-06-04 Revised:2020-08-12 Online:2021-07-10 Published:2021-07-28
  • Contact: WU Ming-hui, E-mail: wumh200711@163.com

摘要: 目的 探讨宫内暴露于妊娠期糖尿病是否增加儿童3岁内发生超重肥胖的风险,为预防儿童肥胖提供科学依据。方法 采用前瞻性队列研究,自2014年9月—2015年8月从北京市16个社区入组符合标准的儿童2 275名,从新生儿期随访至3岁。结果 宫内暴露于妊娠期糖尿病的儿童在1、2、3岁时的BMI均高于非暴露组,但差异无统计学意义(P>0.05)。出生时为巨大儿(OR=2.01,95%CI:1.40~2.89)、母亲孕前体重指数较高(OR=1.09,95%CI:1.06~1.13)、母亲孕期体重增加过多(OR=1.01,95%CI:0.99~1.03)是儿童1岁内超重肥胖的危险因素(P<0.05);家庭人均收入较高(OR=0.83,95%CI:0.71~0.98)是儿童1岁内超重肥胖的保护因素(P<0.05)。出生时为巨大儿(OR=1.66,95%CI:1.07~2.58)、母亲孕前体重指数较高(OR=1.14,95%CI:1.09-1.18)、母亲孕期体重增加过多(OR=1.02,95%CI:1.00~1.04)是儿童2岁内超重肥胖的危险因素(P<0.05);家庭人均收入较高(OR=0.61,95%CI:0.49~0.75)和纯母乳喂养持续6个月(OR=0.61,95%CI:0.45~0.84)是儿童2岁内超重肥胖的保护因素(P<0.05)。出生时为巨大儿(OR=1.89,95%CI:1.23~2.91)、母亲孕前体重指数较高(OR=1.14,95%CI:1.09~1.18)也是儿童3岁内超重肥胖的危险因素(P<0.05);家庭人均收入较高(OR=0.66,95%CI:0.54~0.81)和纯母乳喂养持续6个月(OR=0.55,95%CI:0.40~0.75)是儿童3岁时超重肥胖的保护因素(P<0.05)。辅食添加时间与3岁内儿童超重肥胖无相关性。结论 为了减少儿童在3岁内发生超重肥胖,应严格控制孕妇孕前和孕期的体重,尽可能地坚持纯母乳喂养6个月。

关键词: 儿童肥胖, 妊娠期糖尿病, 纯母乳喂养

Abstract: Objective To investigate the risk of overweight/obesity during 3 years old in children exposed to gestational diabetes mellitus (GDM), in order to provide scientific basis for prevention of childhood obesity. Methods Totally 2 275 eligible children were enrolled in this prospective cohort study from September 2014 to August 2015 in 16 communities of Beijing, and were followed up to 3 years old. Their height and weight were measured at each regular physical examination. Results The body mass index(BMI) of children exposed to GDM was higher than that in the non-exposure group at 1, 2 and 3 years old, but the differences were not significant (P>0.05). The factors that increased the risk of children being overweight and obese within 1 year old included macrosomia (OR=2.01, 95%CI:1.40—2.89), mother with high BMI before pregnancy (OR=1.09, 95%CI:1.06—1.13) and excessive weight gain during pregnancy (OR=1.01, 95%CI:0.99—1.03), while high family income was a protective factor(OR=0.83, 95%CI:0.71—0.98). The factors increasing the risk of children being overweight and obese within 2 years old were macrosomia (OR=1.66, 95%CI:1.07—2.58), mother with high BMI before pregnancy(OR=1.14, 95%CI:1.09—1.18) and excessive weight gain during pregnancy(OR=1.02, 95%CI:1.00—1.04), while factors decreased the risk included higher level of family incomes (OR=0.61, 95%CI:0.49—0.75) and exclusive breastfeeding for 6 months (OR=0.61, 95%CI:0.45—0.84). Factors increasing the risk of children being overweight and obese within 3 years old were macrosomia (OR=1.89, 95%CI:1.23—2.91) and mother with high BMI before pregnancy (OR=1.14, 95%CI:1.09—1.18),while high family incomes (OR=0.66, 95%CI: 0.54—0.81) and exclusive breastfeeding for 6 months (OR=0.55, 95%CI:0.40—0.75) were protective factors for overweight and obese within 3 years old. Conclusion In order to reduce the overweight and obesity of children within 3 years old, the weight of pregnant women before and during pregnancy should be strictly controlled, and exclusive breastfeeding should be adhered to 6 months old as much as possible.

Key words: childhood obesity, gestational diabetes mellitus, exclusive breastfeeding

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