研究生: |
呂忻瑾 |
---|---|
論文名稱: |
台北都會區不同出生體重嬰兒飲食營養與生長發育之前瞻性研究 |
指導教授: | 盧立卿 |
學位類別: |
碩士 Master |
系所名稱: |
人類發展與家庭學系 Department of Human Development and Family Studies |
論文出版年: | 2008 |
畢業學年度: | 96 |
語文別: | 中文 |
論文頁數: | 334 |
中文關鍵詞: | 嬰兒期營養 、嬰兒生長發育 、副食品添加 、哺餵方式 |
英文關鍵詞: | infant nutrition, growth and development in infancy, complementary food, feeding pattern |
論文種類: | 學術論文 |
相關次數: | 點閱:228 下載:17 |
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影響嬰兒生長之相關因素有許多,除了先天遺傳基因及其出生體型,出生後良好的營養素攝取也佔極大的影響力。本研究採前瞻性世代追蹤設計,以電訪及郵寄問卷方式追蹤嬰兒出生至一歲間生長情況,探討影響成長之相關因素,如父母體型、餵食方式與營養素攝取、家庭背景環境等。受試者分別是於民國91年及93年間於台北市立婦幼醫院及台大醫院進行招募。研究之初共有280名新生兒參與,自第2個月開始共有261名嬰兒被持續追蹤至滿週歲;依照出生體重25及75百分位將嬰兒分成相對低出生體重嬰兒(relative low birth- weight infants, rLBW)95人、相對適當出生體重嬰兒(relative adequate- birth weight infants, rABW)74人、相對高出生體重嬰兒(relative high birth-weight infants, rHBW)92人。所有統計分析方式皆以SPSS12.0及STATA8.0進行。
結果發現三組嬰兒出生體重分別為2753.5±144.0公克、3185.1±204. 7公克及3771.2±241.1公克,滿一歲時體重仍維持顯著差異8991.0±975.6公克、9808.6±1050.4公克、10378.3±1030.8公克,但比較體型增加倍數與體重增加百分比(Infant weight gain percentage, IWG%)後發現rLBW嬰兒生長速度較其他兩組快速,體重倍數分別是3.3、3.1、2.8倍,而體重增加百分比為227%、206%及176%。在哺餵方式上,嬰兒2個月時有29.6%嬰兒主要採取母乳哺餵、混合哺餵者為10.4%、配方奶者為60%;所有嬰兒平均開始添加副食品月齡為第5.2個月,最常被使用的副食品為水果/果汁、嬰兒米粉、稀飯及餅乾等,平均開始使用固體食物為正餐時間為第7.8個月,嬰兒滿一歲時僅有24.2%一天使用三次以上固體食物為正餐,有8.0%尚未使用固體食物為正餐,顯示出多數一歲嬰兒(75.8%)仍以奶類為主要熱量來源。營養素攝取部份,第2個月熱量攝取為548大卡,一歲時上升至835大卡,隨月齡增加醣類百分比及蛋白質百分比漸增加,分別由46.0%與9.4%上升至57.0%與13.0%,而脂肪百分比逐漸降低,自45.3%下降至30.1%;不同出生體重嬰兒中以rHBW嬰兒熱量攝取較高,rLBW嬰兒較低,但比較各項營養素攝取後發現整體來說rABW嬰兒營養素攝取情況較佳,皆達DRIs建議標準量;副食品攝取熱量也隨年齡增加,6個月平均107.3大卡,一歲時為370大卡。
在此一年中嬰兒平均生病次數為4.07次,最常發生的疾病為上呼吸道感染,平均3.21次,一次6.64天,不同出生體重嬰兒在健康狀況方面並無差異。嬰兒在此一年間體重及身長與母親的身高及未懷孕前體重皆呈顯著正相關(p<0.05),與父親體型亦呈正相關,但達顯著值較少,顯示出母親體型對嬰兒影響較大;以淨相關分析發現副食品中攝取營養素較整日飲食攝取對嬰兒一歲體型影響力來得大;不同哺餵方式嬰兒在6個月後體型出現顯著差異(p<0.05),顯示出不同哺餵方式對嬰兒生長速度有所影響。再以多元迴歸方式分析與嬰兒一歲體型相關因素,嬰兒一歲體重及體重增加百分比與出生體重、性別、哺餵方式有顯著相關(p<0.05),一歲身長與出生身長、性別、父母親身高有顯著相關(p<0.05),一歲時體重z分數改變量與出生體重及哺餵方式有顯著相關(p<0.05),由多元迴歸結果顯示出生時體型、性別、哺餵方式等非飲食因子對嬰兒一歲時體型預測力較強,尤其出生體重對一歲體重預測力為15.5%,出生身長對一歲身長預測力為12.6%。
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