目的:宫内环境可能对儿童生长发育产生影响,通过流行病学调查研究四川省成都市9~15岁儿童出生胎龄、体重与体格发育指标的关系。方法:调查9~15岁的中小学学生共7194名,根据出生胎龄及体重对儿童进行分类(包括小于胎龄儿、适于胎龄儿、大于胎龄儿),测量身高、体重,并对其家长进行问卷调查。结果:被调查人群小于胎龄儿发生率为6.23%(448例),其中身高未出现“追赶生长”(低于均值两个标准差)为5.13%,且多个年龄段儿童平均身高低于适于胎龄儿(P<0.05)。大于胎龄儿发生率为18.06% (1299例),大于胎龄儿中超重发生率为13.78% (179 例),肥胖发生率为4.39%(57例),且多个年龄段儿童平均体重大于适于胎龄儿(P<0.05)。结论:出生时为小于胎龄儿、大于胎龄儿的儿童在远期生长发育中,可以出现身高和体重异于正常儿童,应关注这类孩子在学龄期的身高体重发育情况。
Abstract
OBJECTIVE: As the intrauterine environment can affect childhood growth and development, this study aims to understand the relationship between birth gestational age, birth weight and physique development in 9 to 15-year-old children by a cross sectional investigation in Chengdu City, Sichuan Province. METHODS: A total of 7194 9 to 15-year-old school children were classified according to birth gestational age and birth weight: small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA). Their heights and weights were measured. Parents completed a questionnaire. RESULTS: The prevalence of SGA was 6.23% (448 cases), and 5.13% of children in the SGA group did not undergo "catch-up growth" (lower than -2 SD). The mean height in these children at various stages was significantly lower than in the AGA group (P<0.05). The prevalence of LGA was 18.06% (1299 cases). A total of 179 children (13.78%) were found to be overweight and 57 children (4.39%) were found to be obese in the LGA group. The mean weight in the LGA group at various stages was significantly higher than in the AGA group (P<0.05). CONCLUSIONS: Height and weight development in children born SGA and LGA are different from normal children. More attention should be given to aspects of height and weight development in these school children.
关键词
小于胎龄儿 /
大于胎龄儿 /
身高 /
体重 /
儿童
Key words
Small for gestational age /
Large for gestational age /
Height /
Weight /
Child
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参考文献
[1]Deng HZ, Li YH, Su Z, Ma HM, Huang YF, Chen HS, et al. Association between height and weight catch-up growth with insulin resistance in pre-pubertal Chinese children born small for gestational age at two different ages[J]. Eur J Pediatr, 2011, 170(1): 75-80.
[2]Maiorana A, Cianfarani S. Impact of growth hormone therapy on adult height of children born small for gestational age[J].Pediatrics, 2009, 124(3): e519-e531.
[3]Ranke MB, Lindberg A. KIGS International Board. Prediction models for short children born small for gestational age (SGA) covering the total growth phase. Analyses based on data from KIGS(Pfizer International Growth Database)[J].BMC Med Inform Decis Mak, 2011, 11: 38.
[4]Oken E, Gillman MW. Fetal origins of obesity[J].Obes Res, 2003, 11(4): 496-506.
[5]Kuhle S, Allen AC, Veugelers PJ.Perinatal and childhood risk factors for overweight in a provincial sample of Canadian Grade 5 students[J]. Int J Pediatr Obes, 2010, 5(1): 88-96.
[6]Wang Y, Gao E, Wu J, Zhou J, Yang Q, Walker MC, et al. Fetal macrosomia and adolescence obesity: results from a longitudinal cohort study[J]. Int J Obes, 2009, 33(8): 923-928.
[7]李辉,季成叶,宗心南,张亚钦.中国0~18岁儿童、青少年身高、体重的标准化生长曲线[J].中华儿科杂志,2009,47(7):487-492.
[8]金汉珍.新生儿分类[M]//胡亚美,江载芳.诸福棠实用儿科学.第7版.北京:人民卫生出版社,2002:409-410.
[9]林汉华.身材矮小[M]//石淑华.儿童保健学. 第2版.北京:人民卫生出版社,2005: 195.
[10]中国肥胖问题工作组.中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J].中华流行病学杂志,2004,25(2):97-102.
[11]陈兆文,李伟华,周海燕,濮泽琼,林亚芬,陈碧琴,等.200例0~2岁宫内发育迟缓儿的生长方式分析[J].上海医学,2005,28(2): 122-125.
[12]崔继华.杨慧明.小于胎龄儿与生长激素治疗[J].中华妇幼临床杂志(电子版),2010,4(6):146-149.
[13]赵枰,张秀琳,郁超,鲁晓燕,王咏梅.宫内发育迟缓儿脐血胰岛素样生长因子-1、胰岛素和生长激素水平测定及意义[J].中国当代儿科杂志,2010,10(12):771-773.
[14]Prader A, Tanner JM, von Harnack G. Catchup growth following illness or starvation. An example of developmental canalization in man[J]. J Pediatr, 1963, 62: 646-659.
[15]王福文,陈乐明.小于胎龄儿的研究[J].中国新生儿科杂志,2009,24(1):60-62.
[16]Saenger P, Czernichow P, Hughes I, Reiter EO. Small for gestational age: short stature and beyond[J]. Endcr Rev, 2007, 28(2): 219-251.
[17]巩纯秀,黄慧.小于胎龄儿的诊断和治疗[J].实用儿科临床杂志,2009,24(20):1622-1624.
[18]季成叶.从胎儿到青春期—肥胖发生和流行的生长发育轨迹[J].中国儿童保健杂志,2010,18(6):445-447.