Why are babies getting bigger? Temporal trends in fetal growth and its determinants
Why are babies getting bigger? Temporal trends in fetal growth and its determinants
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DOI：
10.1067/mpd.2002.128029
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发表时间：
2002-10-01
影响因子：
5.1
通讯作者：
Wen, SW
中科院分区：
文献类型：
--
作者：
Kramer, MS;Morin, I;Wen, SW
目的：描述胎儿“生长”的时间趋势，并检查社会人口统计学、人体测量学和其他决定因素的作用。研究设计：对 61,437 名胎龄 22 至 43 周的非畸形单胎活产进行医院队列研究。检查了四个主要指标：（1）出生体重，（2）出生体重同胎龄 Z 评分，（3）小于胎龄（SGA）和（4）大于胎龄（LGA），后 3 项指标基于最近开发的基于人口的加拿大参考资料。孕龄，如果通过早期超声检查确认（1 周），则基于末次正常月经。结果：大于或等于 37 周的婴儿的平均出生体重和 Z 评分显着增加 (P < .0001)，% SGA 相应减少，% LGA 增加。在 34 至 36 周或 33 周的出生中没有观察到一致的趋势。当通过多重逻辑回归控制母亲孕前体重指数、妊娠体重增加、身高、吸烟以及其他临床和社会人口因素的同时变化时，足月婴儿的时间趋势不再明显。结论：母亲人体测量的增加、吸烟的减少以及社会人口因素的变化导致了足月或足月后出生的婴儿体重的增加。
Objectives: To describe temporal trends in fetal "growth" and to examine the roles of sociodemographic, anthropometric, and other determinants.Study design: Hospital-based cohort study of 61,437 nonmalformed singleton live births at 22 to 43 weeks' gestational age. Four main measures were examined: (1) birth weight, (2) birth weight-for-gestational-age Z score, (3) small-for-gestational-age (SGA), and (4) large-for-gestational age (LGA), with the latter 3 measures based on a recently developed population-based Canadian reference. Gestational age,vas based on the last normal menstrual period if confirmed (1 week) by early ultrasonogram.Results: The mean birth weight and Z score increased significantly (P < .0001) among infants greater than or equal to37 weeks, with a corresponding reduction in % SGA and a rise in % LGA. No consistent trends were seen among births 34 to 36 or: 33 weeks. When simultaneous changes in maternal prepregnancy body mass index, gestational weight gain, height, cigarette smoking, and other clinical and sociodemographic factors were controlled by using multiple logistic regression, the temporal trends for term infants were no longer evident.Conclusions: Increases in maternal anthropometry, reduced cigarette smoking, and changes in sociodemographic factors have led to an increase in the weight of infants born at or after term.