Oken Emily, Rifas-Shiman Sheryl L, Field Alison E, Frazier A Lindsay, Gillman Matthew W
Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Channing Laboratory, Brigham and Women's Hospital, Boston, Massachusetts 02215, USA.
Obstet Gynecol. 2008 Nov;112(5):999-1006. doi: 10.1097/AOG.0b013e31818a5d50.
To study associations of maternal gestational weight gain with offspring weight status in adolescence.
We surveyed 11,994 adolescents aged 9-14 years enrolled in the Growing Up Today Study cohort and their mothers, members of the Nurses' Health Study II. We used multivariable linear and logistic regression to study associations of gestational weight gain with offspring adiposity.
Mean (standard deviation) gestational weight gain was 31.5 (11.2) pounds, and offspring body mass index (BMI) z score (BMI standardized for age and sex) was 0.15 (1.0) units; 6.5% of adolescents were obese (BMI 95th percentile or higher) (BMI is calculated as weight [kg]/[height (m)]2). Gestational gain was linearly associated with adolescent adiposity: compared with 20-24 pounds, gain less than 10 pounds was associated with child BMI z score 0.25 units lower (95% confidence interval [CI] -0.47 to -0.04), and gain 45 pounds or more with BMI z score 0.18 units higher (95% CI 0.11-0.25). Compared with women with adequate gain according to 1990 Institute of Medicine guidelines, women with excessive gain had children with higher BMI z scores (0.14 units, 95% CI 0.09-0.18) and risk of obesity (odds ratio 1.42, 95% CI 1.19-1.70). The predicted prevalence of term low birth weight declined modestly across the range of gain (2% for gain less than 10 pounds, 1% for gain 45 pounds or more), whereas term high birth weight increased dramatically with higher gain (10% for gain less than 10 pounds, 35% for gain of 45 pounds or more).
Gestational weight gain is directly associated with BMI and risk of obesity in adolescence. Revised gestational weight-gain guidelines should account for influences on child weight.
II.
研究孕期体重增加与子代青春期体重状况之间的关联。
我们对参加“今日成长研究队列”的11994名9至14岁青少年及其母亲（护士健康研究II的成员）进行了调查。我们使用多变量线性和逻辑回归分析来研究孕期体重增加与子代肥胖之间的关联。
孕期平均体重增加（标准差）为31.5（11.2）磅，子代体重指数（BMI）z评分（根据年龄和性别标准化的BMI）为0.15（1.0）单位；6.5%的青少年肥胖（BMI处于第95百分位或更高）（BMI的计算方法为体重[千克]/[身高（米）]²）。孕期体重增加与青少年肥胖呈线性相关：与增加20至24磅相比，增加不足10磅与子代BMI z评分低0.25单位相关（95%置信区间[CI]为-0.47至-0.04），增加45磅或更多与BMI z评分高0.18单位相关（95%CI为0.11至0.25）。与按照1990年医学研究所指南体重增加适当的女性相比，体重增加过多的女性所生孩子的BMI z评分更高（0.14单位，95%CI为0.09至0.18），肥胖风险更高（比值比1.42，95%CI为1.19至1.70）。足月低出生体重的预测患病率在不同体重增加范围内略有下降（增加不足10磅时为2%，增加45磅或更多时为1%），而足月高出生体重则随着体重增加幅度的增大而显著增加（增加不足10磅时为10%，增加45磅或更多时为35%）。
孕期体重增加与青春期BMI及肥胖风险直接相关。修订后的孕期体重增加指南应考虑对儿童体重的影响。
II级。
