Rooney Brenda L, Schauberger Charles W, Mathiason Michelle A
Gundersen Lutheran Medical Center, La Crosse, Wisconsin 54601, USA.
Obstet Gynecol. 2005 Dec;106(6):1349-56. doi: 10.1097/01.AOG.0000185480.09068.4a.
To estimate the impact of perinatal weight change on obesity, weight gain, and development of obesity-related illnesses 15 years after pregnancy.
Pregnancy-related factors and weights of 795 women were recorded at first prenatal visit and 6 months postpartum and were available through medical record review at 4, 10, and 15 years. Obesity-related illnesses were recorded 15 years later.
A total of 484 (61%) original cohort members were available for follow-up. Weight gain during pregnancy, weight loss by 6 months postpartum, and baseline body mass index (BMI) were all related to current BMI and weight gain at follow-up. Women who breastfed beyond 12 weeks and participated in postpartum aerobic exercise had lower BMI and weight gain 15 years later. By follow-up, 13% had developed diabetes or prediabetes. Thirty percent had developed heart disease, hypertension, or dyslipidemia. Baseline BMI and weight change over 15 years were significant predictors of both diseases. Smoking status at last follow-up was also a significant predictor of heart disease or pre-heart disease.
Excess pregnancy weight gain and failure to lose weight in an appreciable time are indicators of obesity in midlife. Excess weight gain and obesity status are predictors of diabetes and heart disease, although pregnancy-related weight changes alone are not directly related.
评估围产期体重变化对产后15年肥胖、体重增加及肥胖相关疾病发生发展的影响。
记录795名女性首次产前检查及产后6个月时与妊娠相关的因素和体重，并通过4年、10年及15年的病历回顾获取相关信息。15年后记录肥胖相关疾病情况。
共有484名（61%）原队列成员可供随访。孕期体重增加、产后6个月体重减轻及基线体重指数（BMI）均与随访时的当前BMI及体重增加有关。母乳喂养超过12周且参加产后有氧运动的女性15年后BMI及体重增加较低。到随访时，13%的人已患糖尿病或糖尿病前期。30%的人已患心脏病、高血压或血脂异常。基线BMI及15年的体重变化是这两种疾病的重要预测因素。最后随访时的吸烟状况也是心脏病或心脏病前期的重要预测因素。
孕期体重过度增加及未能在适当时间内减重是中年肥胖的指标。体重过度增加及肥胖状态是糖尿病和心脏病的预测因素，尽管仅妊娠相关的体重变化并非直接相关。
