孕期增重对婴幼儿体重和肥胖风险影响的随访研究

Impacts of gestational weight gain on offspring weight and obesity: a 2-year follow up study

摘要:

目的：研究孕期增重对子代0~24个月内体重和肥胖风险的影响。方法：对317名孕产妇进行孕前体重、分娩前体重和一般人口统计学信息调查，在子代出生时及3、6、9、12、18、24个月龄时进行体重、身高测量和母乳喂养调查。结果：Logistic回归分析显示，孕期增重过多会显著增加子代6月龄(RR=3.56, 95% CI: 1.31~8.35)和9月龄(RR=2.87, 95% CI:1.04~3.28)时肥胖的风险，但并未增加12月龄以后的肥胖风险。线性回归模型结果显示，孕期增重与子代在出生时(β=0.032, 95% CI:0.008~0.057)、3月龄(β=0.037, 95% CI: 0.013~0.062)、6月龄(β=0.043, 95% CI: 0.017~0.068)、9月龄(β=0.038, 95% CI: 0.013~0.063)和12月龄(β=0.034, 95% CI: 0.009~0.059)时体重的Z分值间存在显著的线性关联，但这种关联在子代12个月龄后均无统计学意义。结论：孕期增重过多对子代体重发育的影响可从胎儿期持续至整个婴儿期，这种影响在生后第2年会暂时消失。

Abstract:

OBJECTIVE: To evaluate the impacts of maternal weight gain during pregnancy on offspring weight and obesity from birth to 24 months of age. METHODS: The information on maternal pre-pregnancy body mass index (BMI), gestational weight gain and demographic characteristics were collected from 317 pregnant women. The information on offspring weight, BMI and breastfeeding data was obtained from various follow-up examinations from 0 to 24 months of age. RESULTS: The logistic regression analysis showed that excessive gestational weight gain resulted in an increased risk of obesity in children at age of 6 months (adjusted RR=3.56, 95% CI:1.31-8.35) and 9 months (adjusted RR=2.87, 95% CI: 1.04-3.28) after adjustment for potential confounding factors. The linear regression model showed that there were significant correlations between gestational weight gain and Z score of weight in offsprings at birth (β=0.032, 95% CI: 0.008-0.057), 3 months (β=0.037, 95% CI: 0.013-0.062), 6 months (β=0.043, 95% CI: 0.017-0.068), 9 months (β=0.038, 95% CI: 0.013-0.063) and 12 months (β=0.034, 95% CI: 0.009-0.059), but not at 18 months and 24 months. CONCLUSIONS: Excessive gestational weight gain may affect offspring weight and increase the risk of obesity in children from birth to 12 months of age. During their second year of life, this effect will temporarily disappear.