摘要 目的：调查巨大儿出生后的生长情况以及18月龄时超重发生率和相关因素。方法：84例无基础疾病的巨大儿纳入研究，定期随访其生长情况，并比较分析18月龄时超重的相关因素。结果：18月龄时，84例巨大儿中有24%超重（20/84），男婴的超重比例高于女婴（30% vs 11%，P<0.05）。18月龄时超重组的6月龄超重比例及12月龄超重比例均高于非超重组（80% vs 22%，P<0.01；80% vs 13%，P<0.01）。 Spearman相关分析显示，巨大儿出生体重、0~6月体重增长、7~12月体重增长和13~18月体重增长与其18月龄时按身长的体重Z评分均呈正相关（P<0.05），其中0~6月体重增长与18月龄时Z评分相关性最高（r=0.597，P<0.01）。结论：对出生巨大儿，应重点干预出生后6个月内的体重快速增长，尤其是男婴，以预防幼儿期肥胖。
Abstract：OBJECTIVE: To study the growth of macrosomic infants, the incidence of overweight and the factors related to overweight at 18 months old. METHODS: Eighty-four macrosomic infants without underlying diseases were enrolled in this study. Their growth was followed up regularly. Factors related to overweight at 18 months old were investigated. RESULTS: Twenty infants (24%) showed as overweight at 18 months old. More male infants were overweight than female infants (30% vs 11%; P<0.05). The overweight infants at 18 months old had a higher proportion of overweight at 6 months (80% vs 22%; P<0.01) and at 12 months old (80% vs 13%; P<0.01) than non-overweight infants at 18 months. The spearman correlation analysis demonstrated that weight-for-length Z score at 18 months old was positively correlated with birth weight and weight gain between 0 to 6 months, 7 to 12 months and 13 to 18 months (P<0.05). The strongest correlation was observed between weight gain form 0 to 6 months and weight-for-length Z score at 18 months old (r=0.597, P<0.01). CONCLUSIONS: More attention should be given to the aspect of rapid weight gain in the first 6 months of life in macrosomic infants, especially males, to prevent obesity in early childhood.
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