From the Center for Health Research, Northwest/Hawaii/Southeast, Kaiser Permanente Northwest, Portland, Oregon; and Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Obstet Gynecol. 2009 Nov;114(5):1069-1075. doi: 10.1097/AOG.0b013e3181baeacf.
To evaluate the incremental effect of weight gain above that recommended for term pregnancy (15 pounds) on postpartum weight retention at 1 year among obese women.
In a retrospective cohort study, we identified 1,656 singleton gestations resulting in live births among obese women (body mass index at or above 30 kg/m) between January 2000 and December 2005 in Kaiser Permanente Northwest. Pregnancy weight change (last available predelivery weight minus weight at pregnancy onset) was categorized as less than 0, 0-15, greater than 15 to 25, greater than 25 to 35, and greater than 35 pounds. Postpartum weight change (weight at 1 year postpartum minus weight at pregnancy onset) was defined as less than 0, 0-10, and greater than 10 pounds.
Total gestational weight gain was -33.2 (weight loss) to +98.0 pounds (weight gain). Nearly three fourths gained greater than 15 pounds, and they were younger and weighed less at baseline than women who gained 15 pounds or less. Pregnancy-related weight change showed a significant relationship with postpartum weight change. For each pound gained during pregnancy, there was a 0.4-pound increase above baseline weight at 1 year postpartum. In adjusted logistic regression models, the risk of a postpartum weight greater than 10 pounds over baseline was twofold higher for women gaining greater than 15 to 25 pounds compared with women gaining 0-15 pounds (odds ratio [OR] 2.18, 95% confidence interval [CI] 1.54-3.10), fourfold higher for women gaining greater than 25 to 35 pounds (OR 3.91, 95% CI 2.75-5.56), and almost eightfold higher for women gaining greater than 35 pounds (OR 7.66, 95% CI 5.36-10.97).
Incremental increases in gestational weight gain beyond the current recommendation for obese women substantially increase the risk of weight retention at 1 year postpartum.
II.
评估超重孕妇（体重超过推荐值 15 磅）产后 1 年体重保留量的增量效应。
在一项回顾性队列研究中，我们在 2000 年 1 月至 2005 年 12 月期间，在 Kaiser Permanente Northwest 识别出 1656 例由肥胖女性（体重指数在 30kg/m2 或以上）引起的单胎活产妊娠。妊娠体重变化（最后一次可获得的产前体重减去妊娠起始时的体重）分为小于 0、0-15、大于 15-25、大于 25-35 和大于 35 磅。产后体重变化（产后 1 年体重减去妊娠起始时的体重）定义为小于 0、0-10 和大于 10 磅。
总妊娠体重增加为-33.2（体重减轻）至+98.0 磅（体重增加）。近四分之三的孕妇体重增加超过 15 磅，与体重增加 15 磅或以下的孕妇相比，她们更年轻，基线体重更轻。妊娠相关体重变化与产后体重变化呈显著关系。在调整后的逻辑回归模型中，与体重增加 0-15 磅的孕妇相比，体重增加 15-25 磅的孕妇产后体重增加超过基线的风险高两倍（比值比[OR]2.18，95%置信区间[CI]1.54-3.10），体重增加 25-35 磅的孕妇风险高四倍（OR 3.91，95% CI 2.75-5.56），体重增加 35 磅以上的孕妇风险高近八倍（OR 7.66，95% CI 5.36-10.97）。
超重孕妇的妊娠体重增加超出当前推荐值，会显著增加产后 1 年体重保留的风险。
II。
