Period-specific growth, overweight and modification by breastfeeding in the GINI and LISA birth cohorts up to age 6 years
Period-specific growth, overweight and modification by breastfeeding in the GINI and LISA birth cohorts up to age 6 years
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DOI：
10.1007/s10654-009-9356-5
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发表时间：
2009-08-01
影响因子：
13.6
通讯作者：
Heinrich, Joachim
中科院分区：
文献类型：
--
作者：
Rzehak, Peter;Sausenthaler, Stefanie;Heinrich, Joachim
儿童的体重/生长发育因年龄而异，可能会受到母乳喂养的影响。因此，我们评估了从出生到 6 岁的体重、身长、体重指数和超重/肥胖发展速度，以及与母乳喂养的关系。本研究的方法基于 GINI-plus 和 LISA-plus 出生队列的汇总数据，并跟踪了德国四个研究中心的 7,643 名健康足月新生儿。最多可进行九种人体测量。超重/肥胖是根据世界卫生组织儿童生长标准定义的百分位数。全母乳喂养的定义是母乳喂养至少 4 个月。应用分段线性随机系数模型来评估 0-3、3-6、6-12、12-24 个月以及 24 个月后的生长轨迹和速度。体重、身长和体重指数的发展速度在出生后的前 3 个月内最高，并在随后的时期以不同的速度下降。对于超重和肥胖，峰值速度估计在 6-12 个月和 3-6 个月期间。母乳喂养儿童与其他儿童的体重增加速度差异在前 3 个月为 -18 克/月，第 3 个月至第 6 个月为 -93 克/月，第 6 至 12 个月为 -14 克/月，第 24 个月后为 -3 克/月。母乳喂养和非母乳喂养的儿童的长度速度没有差异。随着时间的推移，在对研究中心、社会经济地位和母亲怀孕期间吸烟进行调整后，估计母乳喂养的儿童超重的风险略低（差异<2%）。与混合喂养或配方奶喂养的婴儿相比，全母乳喂养的婴儿在出生后 12 个月内体重增加较少，但身长增长相同。母乳喂养对超重的保护作用与其在婴儿早期的体重速度调节作用有关。
Children's weight/growth development is age-specific and may be influenced by breastfeeding. We therefore assessed velocities of weight, length, body-mass-index and overweight/obesity development from birth up to age 6 years overall and in relation to breastfeeding. The method of this study is based on pooled data of the birth-cohorts GINI-plus and LISA-plus and follows 7,643 healthy full-term neonates in four study-centers in Germany. Up to nine anthropometric measurements are available. Overweight/obesity is percentile-defined according to WHO-Child-Growth-Standards. Fully-breastfed is defined as breastfed for at least 4 months. Piecewise-linear-random-coefficient-models were applied to assess growth trajectories and velocities between 0-3, 3-6, 6-12, 12-24 and beyond 24th months. Velocities for weight-, length- and BMI-development are highest in the first 3 months after birth and diminish, with differing pace, in the periods that follow. For overweight and obesity, peak-velocities are estimated in periods 6-12 and 3-6 months. The difference in the velocity of weight gain for breastfed vs. other children is -18 g/month in the first 3 month, -93 g/month between month 3 and 6, -14 g/month between month 6 and 12 and -3 g/month beyond the 24th month. Velocities in length are not different between breastfed and non-breastfed children. Over time, a slightly lower risk (difference < 2%) of being overweight was estimated for breastfed children, after adjustment for study-center, socio-economic-status and maternal smoking in pregnancy. Infants fully-breastfed gain less weight, but grow equally in length in the first 12 months of life versus mixed or formula-fed children. The protective effect of breastfeeding on becoming overweight is related to its weight-velocity-modifying-effect in early infancy.