8个城市1～4岁母乳喂养儿童体格生长百分位曲线研究

摘要

目的 制定城市母乳喂养儿童1～4岁年龄别体重、身长(身高)、头围和BMI百分位参考值及百分位曲线.方法 利用2008-2012年我国8个城市地区1 025名母乳喂养儿童1～4岁期间的体格生长纵向随访数据,采用MLwiN2.25软件构建年龄别体重、年龄别身长(身高)、年龄别头围和年龄别BMI多水平模型,同期引入家庭社会人口学特征、母亲围产期因素、父母生物学特征以及婴儿性别、年龄、泥糊状食物摄入、患病情况等相关因素.基于模型进行体格生长指标百分位参考值(P3、P15、P50、P85、P97)预测以及百分位曲线的拟合.结果 制定出城市母乳喂养儿童1～4岁体格生长百分位参考值及相关百分位曲线.男、女童年龄别体重、身长(身高)、头围和BMI比较差异均有统计学意义(均P＜0.001),且男童的体重、身长(身高)、头围和BMI比女童分别平均高0.56 ～ 0.76 kg、0.89～ 1.12 cm、0.64～ 0.91 cm、0.31～ 0.52 kg/m2.结论 本研究结果来源于纵向数据,能够为我国城市地区母乳喂养儿童体格发育评价提供更为科学的循证依据.%Objective To construct the growth percentile curves of weight-,length/height-,head circumference and BMI for 1 to 4 year-olds who had been breastfed in urban areas.Methods Data was from the longitudinal study on 1 025 breastfed children aged 1 to 4 years,in 8 urban areas during 2008-2012.MLwiN2.25 was selected to construct the multi-level models of weight-for-age,length for-age,head circumference-for-age and BMI-for-age.The models included many growth relevant factors including gender,age,family and social demographic characteristics,perinatal factors,parent biological characteristics,dietary patterns and diseases of childen.Based on these models,predicted values (P3,P15,P50,Ps5,P97) were estimated to fit the percentiles reference curves.Results The percentiles reference curves of weight-,length/height,head circumferenceand BMI-for-age for the 1-4 year-olds who had been breastfed in the urban areas were developed.Differences of all the indicators between boys and girls were statistically significant (P＜0.001).Weight,length/height,head circumference and BMI were higher in boys than those in girls,with an average differences as 0.56-0.76 kg,0.89-1.12 cm,0.64-0.91 cm and 0.31-0.52 kg/m2.Conclusion The percentiles reference curves on growth,constructed by the longitudinal observational data and scientific method,were important in reflecting the development ofbreastfed children in urban areas.