文章摘要
李苹,尚煜,刘雅静,昌雪莲,姚红阳,梁爱民,齐可民.孕期二十二碳六烯酸补充对婴儿生长发育和体质指数影响[J].中华流行病学杂志,2018,39(4):449-454
孕期二十二碳六烯酸补充对婴儿生长发育和体质指数影响
Effect of docosahexenoic acid supplementation on infant's growth and body mass index during maternal pregnancy
收稿日期:2017-08-08  出版日期:2018-04-18
DOI:10.3760/cma.j.issn.0254-6450.2018.04.012
中文关键词: 孕期  二十二碳六烯酸  婴儿  生长发育
英文关键词: Pregnancy  Docosahexenoic acid  Infants  Growth and development
基金项目:北京市自然科学基金(7174302);荷兰Nutricia Research Foundation(2014-07,2015-E2);北京市自然科学基金-三元联合资助项目(S150006)
作者单位E-mail
李苹 100045 北京, 国家儿童医学中心 首都医科大学附属北京儿童医院 北京市儿科研究所营养研究室  
尚煜 100000 北京市朝阳区妇幼保健和计划生育服务中心儿童保健科  
刘雅静 101300 北京市顺义区妇幼保健院儿童保健科  
昌雪莲 100045 北京, 国家儿童医学中心 首都医科大学附属北京儿童医院 北京市儿科研究所营养研究室  
姚红阳 100045 北京, 国家儿童医学中心 首都医科大学附属北京儿童医院 北京市儿科研究所营养研究室  
梁爱民 100045 北京, 国家儿童医学中心 首都医科大学附属北京儿童医院保健中心  
齐可民 100045 北京, 国家儿童医学中心 首都医科大学附属北京儿童医院 北京市儿科研究所营养研究室 qikemin@bch.com.cn 
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中文摘要:
      目的 探讨孕期二十二碳六烯酸(DHA)补充对婴儿生长发育和BMI影响。方法 采用队列研究,以2016年5-10月北京市两家区级妇幼保健院建档的1 516名孕产妇及其婴儿为研究对象,利用问卷调查在临产前获取孕产妇年龄、身高、体重、孕期体重增加量、分娩方式、孕周数、鱼类食用量及DHA补充情况。根据孕期DHA补充情况分为DHA补充组及非补充组。记录婴儿出生体重、身长、头围及BMI。随访至婴儿6月龄,监测其生长发育相关指标;其间收集产后1~3个月的母乳,用于测定脂肪酸含量。结果 孕妇DHA补充率为47.76%,其中孕早、中期即开始补充的分别占49.31%和39.64%。孕早期即开始补充DHA的孕妇母乳DHA含量高于非补充组,差异有统计学意义(P=0.006),而DHA补充始于孕中及晚期者未能提升母乳DHA含量(P>0.05)。孕期DHA补充组婴儿出生及6月龄时身长和头围均高于非补充组,差异有统计学意义(P<0.01),而BMI值低于非补充组,差异有统计学意义(P<0.01)。进一步发现,孕早期和中期即开始DHA补充组婴儿出生及6月龄时身长均高于非补充组及孕晚期补充组,差异有统计学意义(P<0.05);而BMI值低于非补充组及孕晚期补充组,差异有统计学意义(P<0.01)。孕早期即开始DHA补充组婴儿出生时头围高于非补充组,差异有统计学意义(P=0.001),而6月龄时头围及头围增量均高于其他各组,差异有统计学意义(P<0.01)。偏回归分析显示孕期DHA补充与婴儿出生及6月龄身长(r=0.324,r=0.216)、头围(r=0.221,r=0.302)及6个月内头围增量(r=0.276)呈正相关(P<0.05),而与BMI值(r=-0.310,r=-0.371)呈负相关(P<0.05)。结论 孕期DHA补充可促进胎儿与其出生后身长和头围发育,降低BMI值,并且补充越早效果越明显;这有助于更好地保证婴儿生长发育、预防后期肥胖发生。
英文摘要:
      Objective To investigate the effects of docosahexenoic acid (DHA) supplementation on infant's growth and BMI during pregnancy. Methods A total of 1 516 healthy pregnant women delivered their babies in two maternal and child health care hospitals in Beijing and were chosen as the subjects in this cohort study from May to October 2015. Self-developed questionnaires were used to gather general information of the subjects, including age, height, weight, weight gain during pregnancy, delivery mode, DHA supplementation etc., before giving birth. Information on body length, weight, head circumference and BMI at birth and 6 months postnatal, of the infants were recorded. Breast milk was collected to test the fatty acid profiles by using the gas chromatography (GC) method at one to three months postnatally. Results The overall rate of DHA supplementation was 47.76% among the pregnant women, in which introduction of DHA from the early and second stage of the pregnancy accounted for 49.31% and 39.64% respectively. When DHA supplementation began from the early pregnant stage, the DHA concentration showed an increase in the milk (P<0.05), whereas the supplementation began from the second and third stages did not affect the milk DHA concentration (P>0.05). Higher height and lower BMI were seen in the infants at birth and 6 months in the supplementation group when comparing to the non-supplementary group (P<0.05), with the greatest effects noticed in the earliest supplementation group. Specifically, the head circumference appeared larger from the early pregnant stage in the DHA supplementary group, than that in the non-supplement group (P=0.001). The increment of head circumference was larger than that in the other groups when the infants were 6-month old (P<0.01). Results from the partial regression analysis showed that during pregnancy, there were positive correlations between DHA supplementation and height (r=0.324, r=0.216), head circumference (r=0.221, r=0.302) as well as the increment of head circumference (r=0.276) at birth and 6 months (P<0.05). Whereas, a negative correlation was shown between DHA and the infants' BMI (r=-0.310, r=-0.371) (P<0.05) when supplementation was given during maternal pregnancy. Conclusions When DHA supplementation program was carried out during maternal pregnancy, it could increase the height and head circumference and inhibit the rapid increase of BMI in the infants BMI. Our findings seemed helpful in promoting brain development and preventing the childhood obesity.
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