摘要目的 评估婴儿快速生长对小于胎龄儿(small for gestational age, SGA)和适于胎龄儿(appropriate for gestational age, AGA)学龄前期超重及血压升高的影响. 方法 选取2017年3月1日至2018年6月30日天津市50所市级管理的幼儿园的大班儿童12 150例为研究对象进行横断面调查.测量儿童身高、体重和血压,并回顾性收集其出生及1岁时的身长及体重等数据.定义出生至1岁的身长别体重Z评分差值＞0.67为快速生长,分析快速生长与学龄前期超重和血压的关系.采用t检验、方差分析和χ2检验进行统计学分析. 结果 快速生长组儿童在学龄前期超重率[28.6%(2 095/7 328)与17.5%(842/4 822),t=196.457]、收缩压[(99.4±10.0)与(98.4± 10.1) mmHg(1 mmHg=0.133 kPa),t=29.260]和舒张压[(60.0±7.7)与(59.4±7.8) mmHg, t=16.079]均高于非快速生长组(P值均＜0.001).在SGA中,快速生长者学龄前期体重[(21.5±4.4)与(19.2±3.7) kg,t=3.747]、身高[(117.4±5.5)与(114.8±5.4) cm,t=3.557]和收缩压[(98.4± 9.9)与(95.6±11.2) mmHg,t=2.080]均高于非快速生长者(P值均＜0.05).SGA学龄前期超重率[17.5%(144/824)与24.7%(2 793/11 326),t=21.630]和收缩压[(98.2±10.0)与(99.0± 10.1) mmHg,t=2.431] 均低于 AGA(P 值均＜0.05),但快速生长 AGA 中有 29.8%(1 958/6 564)存在超重情况. 结论 婴儿期快速生长可能与儿童学龄前期超重和血压升高有关.应重视AGA及SGA婴儿早期的适宜体重生长.

abstractsObjective To investigate whether rapid weight gain in the first year of life was associated with incidence of overweight and higher blood pressure in small for gestational age (SGA) and appropriate for gestational age (AGA) infants at preschool age. Methods From March 1, 2017 to June 30, 2018, a total of 12 150 children aged six years from 50 municipal kindergartens in Tianjin were enrolled in a cross-sectional survey. Their body weight, height and blood pressure were measured. Body length and weight at birth and one year of age were retrospectively collected. Rapid catch-up growth was defined as the difference of weight-for-height Z-score between one year old and at birth >0.67. The relationship between rapid growth with overweight and blood pressure in SGA and AGA infants at preschool age were analyzed using t test, analysis of variance and Chi-square test. Results At the age of six, children with rapid growth had a higher rate of overweight [28.6% (2 095/7 328) vs 17.5% (842/4 822), t=196.457, P<0.001], and higher systolic blood pressure [(99.4±10.0) vs (98.4±10.1) mmHg (1 mmHg=0.133 kPa), t=29.260, P<0.001] and diastolic blood pressure [(60.0±7.7) vs (59.4±7.8) mmHg, t=16.079, P<0.001] compared with children without rapid growth. SGA children with rapid growth had higher body weight [(21.5±4.4) vs (19.2±3.7) kg, t=3.747, P<0.001], height [(117.4±5.5) vs (114.8±5.4) cm, t=3.557, P<0.001] and systolic blood pressure [(98.4±9.9) vs (95.6±11.2) mmHg, t=2.080, P=0.038] compared with those without. Comparing to AGA children, SGA children had lower overweight rate [17.5% (144/824) vs 24.7% (2 793/11 326), t=21.630, P<0.001] and systolic blood pressure [(98.2±10.0) vs (99.0±10.1) mmHg, t=2.431, P=0.015]. Among the AGA children with rapid growth, 29.8% (1 958/6 564) were overweight. Conclusions Rapid growth in infancy is associated with overweight and higher systolic blood pressure at preschool age. A proper weight gain should be emphasized for both SGA and AGA infants.