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【目的】分析青岛地区巨大儿发生的成因及生后生长发育趋势,为孕期指导,产后生长发育监测提供依据。【方法】以1 815例足月巨大儿为观察组,同期足月适于胎龄儿13 409例为对照。比较孕妇孕前体质指数(body massindex,BMI)、孕期增重、身高、糖代谢情况,调查膳食、运动情况,检测80例(40例巨大儿、40例适于胎龄儿)脐血瘦素、脂联素、胰岛素样生长因子-Ⅰ水平,生后3、6、9、12、18、24个月6个年龄监测点监测BMI值。【结果】观察组孕妇孕前BMI值、孕期增重、身高、糖代谢异常率明显高于对照组(χ2值分别为30.06、48.93、68.18、111.75,P<0.05)。膳食中海鲜及水果摄入量高于对照组(P<0.05)。孕期运动时间少于对照组。观察组脐血瘦素、胰岛素样生长因子-Ⅰ明显高于对照组(t值分别为4.59、5.99,P<0.01),脂联素低于对照组(t=8.42,P<0.01)。生后在各监测点观察组超重发生率高于对照组。【结论】青岛地区产妇的孕前BMI、孕期增重、孕母身高、糖代谢异常、孕期运动和饮食是巨大儿发生的成因。巨大儿有与成人肥胖相同的病理基础,结局是生后超重发生率明显增高。
【Objective】 To analyze the genesis, growth and development trend of macrosomia in Qingdao area and provide the basis for the monitoring during pregnancy and postpartum growth and development. 【Methods】 A total of 1 815 full-term hypertensive children were enrolled in this study. 13 409 full-term infants were enrolled in this study. The body mass index (BMI), weight gain, height and glucose metabolism of pregnant women during pregnancy were compared. The dietary and exercise conditions were investigated. The cord blood leptin in 80 cases (40 cases of giant and 40 cases of gestational age) Adiponectin, insulin-like growth factor-Ⅰ levels, 3, 6, 9, 12, 18, 24 months after birth, 6 monitoring points monitoring BMI. 【Results】 The BMI values, weight gain, height and abnormal glucose metabolism rate of pregnant women in observation group were significantly higher than those in control group (χ2 = 30.06, 48.93, 68.18, 111.75 respectively, P <0.05). Dietary seafood and fruit intake was higher than the control group (P <0.05). Pregnancy less exercise time than the control group. The levels of leptin and insulin-like growth factor-Ⅰ in the observation group were significantly higher than those in the control group (t = 4.59, 5.99, respectively, P <0.01), adiponectin was lower than the control group (t = 8.42, P <0.01) After birth, the incidence of overweight in observation group was higher than that in control group. 【Conclusion】 The maternal pre-pregnancy BMI, weight gain during pregnancy, height of pregnant mother, abnormal glucose metabolism, pregnancy movement and diet are the causes of macrosomia in Qingdao area. Huge children have the same pathological basis with adult obesity, the outcome is significantly increased the incidence of post-natal overweight.