| 王政和,徐荣彬,董彦会,阳益德,王烁,王西婕,杨招庚,邹志勇,马军.剖宫产与6~17岁儿童青少年期肥胖的关联研究[J].Chinese journal of Epidemiology,2017,38(12):1598-1602 |
| 剖宫产与6~17岁儿童青少年期肥胖的关联研究 |
| Association between cesarean birth and the risk of obesity in 6-17 year-olds |
| Received:April 23, 2017 |
| DOI：10.3760/cma.j.issn.0254-6450.2017.12.002 |
| KeyWord: 剖宫产 肥胖 儿童青少年 关联分析 |
| English Key Word: Cesarean section Obesity Child and adolescent Association analysis |
| FundProject:2012年卫生公益性行业科研专项（201202010） |
| Author Name | Affiliation | E-mail | | Wang Zhenghe | Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China | | | Xu Rongbin | Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China | | | Dong Yanhui | Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China | | | Yang Yide | Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China | | | Wang Shuo | Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China | | | Wang Xijie | Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China | | | Yang Zhaogeng | Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China | | | Zou Zhiyong | Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China | | | Ma Jun | Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China | majunt@bjmu.edu.cn |
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| Abstract: |
| 目的 探讨剖宫产与儿童青少年期肥胖的关联。方法 采用分层整群抽样方法，在湖南、宁夏、天津、重庆、辽宁、上海和广东7个省份抽取93所中小学校，选取家长问卷中分娩方式等资料完整的42 758名6~17岁中小学生作为研究对象。采用Log-Binomial回归模型分析剖宫产与儿童青少年期肥胖风险的关联。结果 研究对象年龄（10.5±3.2）岁，剖宫产率为42.3%，其中男生（55.9%）显著高于女生（40.6%）（P<0.001）。剖宫产出生的儿童青少年肥胖率（17.6%）显著高于阴道产者（10.2%）（P<0.001）。与阴道产相比，剖宫产显著增加儿童青少年期肥胖的发生风险（OR=1.72，95% CI：1.63~1.82；P<0.001），在调整性别、城乡、喂养方式、胎数、饮牛奶频率、摄入高能量食物频率、摄入油炸食品频率、父母亲文化程度、家庭经济收入、父母亲肥胖、体力活动水平、孕周和出生体重后，该关联仍有统计学意义（OR=1.48，95% CI：1.39~1.57；P<0.001）。结论 剖宫产可能显著增加儿童青少年期发生肥胖的风险，应降低我国孕产妇的剖宫产率。 |
| English Abstract: |
| Objective To explore the association between cesarean section and obesity in child and adolescent.Methods In this study, a total number of 42 758 primary and middle school students aged between 6 and 17 were selected, using the stratified cluster sampling method in 93 primary and middle schools in Hunan, Ningxia, Tianjin, Chongqing, Liaoning, Shanghai and Guangdong provinces and autonomous regions. Log-Binomial regression model was used to analyze the association between cesarean section and obesity in childhood or adolescent.Results Mean age of the subjects was (10.5±3.2) years. The overall rate of cesarean section among subjects attending primary or secondary schools was 42.3%, with 55.9% in boys and, 40.6% in girls respectively and with difference statistically significant (P<0.001). The rate on obesity among those that received cesarean section (17.6%) was significantly higher than those who experienced vaginal delivery (10.2%) (P<0.001).Results from the log-binomial regression model showed that cesarean section significantly increased the risk of obesity in child and adolescent (OR=1.72, 95% CI:1.63-1.82; P<0.001). After adjusting for factors as sex, residential areas (urban or rural), feeding patterns, frequencies of milk-feeding, eating high-energy foods, eating fried foods and the levels of parental education, family income, parental obesity, physical activity levels, gestational age and birth weight etc., the differences were still statistically significant (OR=1.48, 95% CI:1.39-1.57; P<0.001).Conclusion The rate of cesarean section among pregnant women in China appeared high which may significantly increase the risk of obesity in child or adolescent. |
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