本文選題：嬰幼兒 + 體重指數(shù)Z值�。� 參考：《華中科技大學》2013年碩士論文

【摘要】：目的：縱向了解目前我國城市兒童0-2歲期間的生長發(fā)育水平，建立BMI_Z值的預測模型和年齡軌跡。 方法：采用多階段分層隨機抽樣方法，于2009年4月1日-2010年3月31日間在沈陽、武漢和廣州三城市選取符合條件的新生兒，將同意參與項目的家庭作為調查對象進行為期2年的隨訪，內容包括體格測量和飲食、睡眠情況問卷調查等。采用Epidata3.1建立數(shù)據(jù)庫，用SAS9.1軟件進行統(tǒng)計分析，利用混合線性模型建立BMI_Z值的預測模型和年齡軌跡。 結果：（1）一般情況：共收錄新生兒2220名，男女性別比為1.08:1；共隨訪11455人次，總隨訪率為73.71%。 （2）體格發(fā)育水平：①男童身長、體重和體重指數(shù)顯著高于同齡女童（P0.05）；②兒童體重Z值（WT_Z），身長Z值（HT_Z）和BMI_Z值曲線整體右移；③男、女童0-2歲期間高/超高BMI檢出率隨年齡增長逐漸升高，1歲左右達到峰值，2歲時男童超重/肥胖率顯著高于女童（P＝0.0467）。 （3）BMI_Z值的預測模型：通過兒童性別、父母體重狀態(tài)、家庭收入與結構和3月內嬰兒喂養(yǎng)模式等變量來對2歲內兒童BMI_Z值進行預測：①母親孕前超重和肥胖組兒童BMI_Z值平均比正常體重組高0.30，，孕前營養(yǎng)不良組比正常體重組低0.17；②3月純母乳喂養(yǎng)對兒童BMI_Z值影響隨時間發(fā)生變化：3月齡時，純母乳喂養(yǎng)兒童的BMI_Z值高于人工喂養(yǎng)組0.07；6月齡時兩組接近，2歲時，純母乳喂養(yǎng)的兒童BMI_Z值顯著低于人工喂養(yǎng)組0.3；③父親體重狀態(tài)、胎齡、分娩方式也可影響兒童BMI_Z值。 （4）BMI_Z值的年齡軌跡：母親孕前不同體重狀態(tài)對男、女童0-2歲期間原始BMI_Z值年齡軌跡均顯著影響；校正協(xié)變量后，母親孕前體重狀態(tài)對男童BMI_Z值年齡軌跡影響顯著，但未檢出對女童BMI_Z值的作用。 結論：①我國城市0-2歲兒童生長發(fā)育水平良好，并超過了WHO標準，繼續(xù)呈現(xiàn)出生長長期趨勢；②兒童生長水平提高的同時伴隨著BMI_Z值曲線右移，警示兒童早期肥胖問題的出現(xiàn)；③父母體重狀態(tài)、分娩方式、新生兒胎齡和早期喂養(yǎng)模式是我國城市兒童0-2歲期間BMI_Z值的重要預測因子；④母親孕前體重狀態(tài)對男童BMI_Z值年齡軌跡有顯著影響。
[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.
【學位授予單位】：華中科技大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R179

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