足月小于胎龄儿24月龄内体格发育及营养状况研究

The study on physical development and nutritional status of full-term small for gestational age (SGA) infants within 24 months of age

摘要

目的 探讨24月龄内足月小于胎龄儿体格发育及营养状况变化,为其及时干预和管理提供科学依据.方法 选择2018年1月至2024年12月于某医院儿童保健科体检的89370例婴幼儿作为研究对象,根据其出生情况分为足月小于胎龄儿(SGA)组(n＝9767)和足月适于胎龄儿(AGA)组(n＝79603).采集所有研究对象的基础健康数据以及不同月龄的体检数据.采用t检验和卡方检验分析两组不同月龄婴幼儿体格发育状况(包括身长、体重、头围、BMI)以及营养状况(包括消瘦、正常、超重、肥胖).结果 1月龄SGA组婴幼儿的身长、体重、头围、BMI均显著低于AGA组婴幼儿(t值分别为53．36、40．23、34．89、26．50,均P＜0．05).3、6、12、18、24月龄SGA组婴幼儿的身长(t值介于17．72~34．13)、体重(t值介于14．62~26．48)、头围(t值介于12．23~23．68)、BMI(t值介于2．28~10．82)也均显著低于AGA组婴幼儿(均P＜0．05).1月龄至24月龄期间,随月龄增长,两组中营养状况正常的婴幼儿占比均呈上升趋势,消瘦、超重、肥胖占比均呈下降趋势.SGA组中,营养状况正常的婴幼儿占比从1月龄时的88．5％升至24月龄时的96．1％(χ²＝216．64,P＜0．001);AGA组中,该占比从1月龄时的88．6％升至24月龄时的91．5％(χ²＝2191．56,P＜0．001).SGA组中,营养状况正常的女孩占比高于男孩(86．7％vs．84．9％,χ²＝18．51,P＜0．001);AGA组中,营养状况正常的女孩占比同样高于男孩(85．0％vs．81．3％,χ²＝253．71,P＜0．001).结论 至24月龄时,SGA营养状况已追赶上足月AGA,但在体格发育方面,足月小于胎龄儿仍未达到足月适于胎龄儿的水平.该研究结果为体格发育和营养状况不佳婴幼儿的及时干预与及时管理提供支持.

Abstract

Objective To explore the changes in physical development and nutritional status of full-term small-for-gestational-age (SGA) infants within 24 months of age, providing scientific evidence for timely intervention and management. Methods A total of 89,370 infants who underwent health check-ups in the Child Health Department of a hospital from January 2018 to December 2024 were selected as study subjects. They were divided into two groups based on their birth conditions: the SGA group (n=9,767) and the appropriate for gestational age (AGA) group (n=79,603). Basic health data and physical examination data at different months of age were collected for all subjects. The t-test and chi-square test were used to analyze the physical development status (including length, weight, head circumference, BMI) and nutritional status (including underweight, normal, overweight, and obesity) of infants in the two groups at different ages. Results At 1 month of age, the length, weight, head circumference, and BMI of infants in the SGA group were significantly lower than those in the AGA group (t=53.36, 40.23, 34.89, and 26.50, respectively, all P<0.05). At 3, 6, 12, 18, and 24 months of age, the length (t-values ranged from 17.72 to 34.13), weight (t-values ranged from 14.62 to 26.48), head circumference (t-values ranged from 12.23 to 23.68), and BMI (t-values ranged from 2.28 to 10.82) of infants in the SGA group were also significantly lower than those in the AGA group (all P<0.05). From 1 to 24 months of age, as the infants grew older, the proportion of infants with normal nutritional status increased in both groups, while the proportions of underweight, overweight, and obesity decreased. In the SGA group, the proportion of infants with normal nutritional status increased from 88.5% (1 month) to 96.1% (24 months) (χ ²=216.64, P<0.001). In the AGA group, the proportion increased from 88.6% (1 month) to 91.5% (24 months) (χ ²=2191.56, P<0.001). In the SGA group, the proportion of girls with normal nutritional status was higher than that of boys (86.7% vs. 84.9%, χ ²=18.51, P<0.001). In the AGA group, the proportion of girls with normal nutritional status was also higher than that of boys (85.0% vs. 81.3%, χ ²=253.71, P<0.001). Conclusion By 24 months of age, the nutritional status of SGA infants has caught up to that of full-term AGA infants. However, in terms of physical development, full-term small for gestational age infants still have not reached the level of full-term appropriate for gestational age infants. These findings provide support for timely intervention and management of infants with poor physical development and nutritional status.

关键词

足月小于胎龄儿 / 0~24月龄 / 体格发育 / 营养状况

Key words

full-term small-for-gestational-age infant / 0-24 months of age / physical development / nutritional status

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基金资助

国家自然科学基金项目(82103924)