摘要： 目的 研究孕妇孕期增重（GWG）对0~1岁婴儿体质量、身长和脐带血瘦素水平的影响，探讨瘦素在孕妇营养对婴儿体格发育影响中的调控作用。方法 选取2019年9月至2020年9月于中国医科大学附属第四医院住院分娩的464对母子对作为研究对象，并通过问卷调查、分娩记录、随访和主要结果测量，收集孕妇、新生儿和婴儿6月龄及1岁时的信息。采用多重线性回归分析孕妇GWG对0~1岁婴儿体格发育的影响，采用Pearson相关性分析探讨出生体质量与6月龄及1岁婴儿体质量的关系，采用Spearman相关性分析探讨瘦素的作用。结果 孕妇GWG不足和过多的检出率分别为6.3%和70.9%。孕妇GWG过多会导致新生儿出生体质量（β=0.199，95% CI：0.118~0.280，P<0.001）和出生身长（β=0.441，95% CI：0.111~0.771，P<0.05）显著增高，孕妇GWG对6月龄及1岁婴儿的体质量和身长均无显著影响（P>0.05），但新生儿出生体质量与6月龄及1岁婴儿体质量呈正相关（r=0.341，P<0.001和r=0.297，P<0.001）。脐带血瘦素水平与孕妇GWG和新生儿出生体质量均呈正相关（r=0.255，P=0.028和r=0.434，P<0.001）。结论 沈阳市孕妇GWG过多的现象严重，瘦素可能在孕妇GWG过多导致新生儿出生体质量增加中发挥调控作用。

孕妇孕期增重对婴儿体格发育影响的队列研究

路柯^1,2, 丁雅洁^1,2, 张宁馨^1,2, 王雪松^1,2, 胡嘉晋^2,3, 刘洋^2,3, 贾丽红^1,2

1. 中国医科大学公共卫生学院儿少卫生与妇幼保健学教研室, 沈阳 110122;
2. 辽宁省肥胖与糖脂代谢性疾病重点实验室, 沈阳 110122;
3. 中国医科大学健康科学研究院, 沈阳 110122

收稿日期:2022-10-13出版日期:2023-03-30发布日期:2023-03-21
通讯作者:贾丽红E-mail:lhjia@cmu.edu.cn
作者简介:路柯(1998-),女,硕士研究生.
基金资助:国家自然科学基金（82073575）


关键词: 孕妇, 孕期增重, 婴儿, 体格发育, 瘦素
Abstract: Objective To study the effects of pregnant women’s gestational weight gain （GWG） on the weight and length of 0- to 1-year-old infants and the level of leptin in cord blood，and to investigate the regulatory role of leptin in the effects of pregnant women’s nutrition on infant physical development. Methods A total of 464 mother-child pairs hospitalized and delivered in a third-class hospital in The Fourth Hospital of China Medical University were selected as the study participants from September，2019 to September，2020. Information on pregnant women，newborns，and infants at 6 months and 1 year was collected through questionnaire survey，delivery records，follow-up，and measurement of main results. The effect of pregnant women’s GWG on the physical development of 0- to 1-year-old infants was analyzed using multiple linear regression analysis. The relationship between birth weight and the weight of 6-month- and 1-year-old infants was investigated using the Pearson correlation analysis. The role of leptin was investigated using the Spearman correlation analysis. Results The detection rate of insufficient and excessive GWG was 6.3% and 70.9%，respectively. Excessive GWG in pregnant women can significantly increase birth weight （β=0.199，95% CI：0.118-0.280，P<0.001） and length （β=0.441，95% CI：0.111-0.771，P<0.05） in newborns. The pregnant women’s GWG had no significant effect on the weight and length of 6-month- and 1-year-old infants （P>0.05）； however，neonatal birth weight was positively correlated with the weight of 6-month- and 1-year-old infants （r=0.341，P<0.001 and r=0.297，P<0.001）. Cord blood leptin concentrations were positively correlated with pregnant women’s GWG and neonatal birth weight （r=0.255，P=0.028 and r=0.434，P<0.001）. Conclusion A serious phenomenon of excessive GWG was observed among pregnant women in Shenyang，and leptin may play a regulatory role in neonatal birth weight gain caused by excessive maternal GWG.
Key words: pregnant woman, gestational weight gain, infant, physical development, leptin
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