研究生: |
馬家蕙 |
---|---|
論文名稱: |
追蹤台北都會區不同出生體重新生兒至三歲飲食營養與生長發育之研究 A follow-up study from birth to three years old on dietary intakes and growth development for infants with different birth weight in Taipei |
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: | 2010 |
畢業學年度: | 98 |
語文別: | 中文 |
論文頁數: | 329 |
中文關鍵詞: | 相對低出生體重 、相對高出生體重 、嬰幼兒生長發育 、嬰幼兒營養 |
英文關鍵詞: | relative low birth weight infants, relative high birth weight infants, growth status of infants and toddlers, nutrition of infants and toddlers |
論文種類: | 學術論文 |
相關次數: | 點閱:165 下載:17 |
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良好的營養支持是嬰幼兒健全發展的關鍵因素,且不同出生體重可能會影響幼兒生長速度。本研究分析長期追蹤收集不同出生體重新生兒至三歲營養攝取狀況與生長發展之相關資料,並探討各因素間之關係。研究對象分別於民國91及93年間於台北市立婦幼醫院及台大醫院各為130及150位。兩世代採用相同問卷調查法,內容包括嬰幼兒飲食及發展狀況等資料。最後研究結果合併兩世代共186位嬰幼兒至三歲之資料,依出生體重第25及第75百分位分成相對低出生體重(relative low birth-weight infants, rLBW)、相對適當出生體重(relative adequate-birth weight infants, rABW)、相對高出生體重(relative high birth-weight infants, rHBW)三組。資料使用SPSS 12.0及STATA 8.0版進行分析。
結果發現三組幼兒至三歲,rHBW組幼兒之體型(體重、身長、頭圍)仍保持最大,rLBW組體型仍為最小,且三組間具顯著差異;而體型增加倍數三組間也呈顯著差異,並發現rLBW組幼兒生長表現皆較rHBW組快速。以每一年為觀察單位分析則發現,嬰幼兒僅於出生後第一年三組間有顯著差異,出生後第二年及第三年,體重及身長增加倍數於三組間皆無顯著差異,但頭圍增加倍數結果卻不一致。不同出生體重嬰幼兒出生至三歲之生長速度方面包括體重增加倍數、身長增加倍數及頭圍增加倍數分別約為4-5倍、2倍及1.5倍。性別差異方面,男女嬰幼兒從出生至三歲體重上皆達到顯著差異性,三歲時男幼兒高於女幼兒約0.7公斤;身長部份,至三歲時雖男幼兒高於女幼兒0.80公分,但未達顯著差異;頭圍部份,男女嬰幼兒從出生至三歲皆達到顯著差異性,三歲時男幼兒大於女幼兒0.75公分。分析幼兒三歲時體重及BMI依人數平均分成三組,幼兒至三歲時近90 %仍維持原組或只跳一組,由此推論出生體重對於幼兒至三歲時的生長狀況仍具有影響,但未來變化仍須持續追蹤。
不同出生體重三組間並無顯著之飲食型態差異,三歲幼兒平均每日熱量攝取分別為1228大卡,符合於DRIs所建議的1200大卡,而蛋白質攝取量為43.3公克,高於DRIs所建議的20公克;三大營養素百分比方面,蛋白質攝取百分比佔總熱量之14%,脂肪攝取百分比佔總熱量之27%,醣類攝取百分比佔總熱量之58%。幼兒三歲時每日飲食模式中,不同出生體重三組間並無顯著差異,整體分析每日喝奶的次數約為1.9次,而每日以一般家庭飲食為正餐的次數為2.4次。奶類哺餵上約有65%會使用商業化配方奶粉,約30%會使用一般的乳品。三歲時約54%的幼兒對食物有偏食現象,種類依序為蔬菜類、肉類、水果類、魚類、蛋類及奶類。補充劑方面,不同出生體重三組間並無顯著差異,三歲幼兒約60.8%有使用補充劑,最常使用的補充劑以維他命為主,其次依序為乳酸菌、鈣片(粉)、魚肝油、中藥、蜂蜜、鐵劑,母親大多以嬰幼兒健康及成長發育為考量而提供。
健康狀況方面,不同出生體重三組間並無顯著差異,三歲幼兒最常罹患的疾病為上呼吸道感染(主要為感冒),三組間生病頻率及各疾病感染天數,經分析比較後並無差異性。生長分析方面,蛋白質、維生素K、維生素B2、維生素B12、鉀、鈣、泛酸及動物性蛋白的攝取量,皆與幼兒三歲的體重及身長呈顯著正相關(p<0.05)。父母親體重與幼兒三歲體重呈顯著正相關(p<0.05);父母親身高與幼兒三歲時的身長亦成顯著正相關(p<0.05)。經由多元迴歸分析的結果可以得知,幼兒體重方面,父親體重及母親未懷孕體重,對幼兒三歲時體重的解釋力佔有16.2%,三歲時熱量與三大營養的攝取約佔了11.9%的解釋量。身長方面,出生身長及父母親身高對幼兒三歲時身長的解釋力佔有14.9%,三歲時動物性蛋白質及鈣質,分別佔有4.7%及4.4%的解釋力。
本研究除詳盡描述零至三歲嬰幼兒飲食營養變化及生長情形,顯示來自台北市中高階層家庭的幼兒在熱量及營養均充足富裕的環境中,三歲幼兒的生長發育在微量營養素並不匱乏的情況之下,是由熱量和相關營養素的攝取以及父母親的體型所影響與調控,若是能配合均衡而適量的良好飲食營養模式必定能讓幼兒有更適當的生長與健康。
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