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孕前体重指数和孕期体重增加对婴儿体格发育结局的影响。

Effects of pre-pregnancy body mass index and gestational weight gain on infant anthropometric outcomes.

机构信息

Department of Preventive Medicine, Mt Sinai School of Medicine, New York, NY, USA.

出版信息

J Pediatr. 2011 Feb;158(2):221-6. doi: 10.1016/j.jpeds.2010.08.008. Epub 2010 Sep 22.

Abstract

OBJECTIVE

To determine whether pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) influence infant postnatal growth.

STUDY DESIGN

Participants were from the Pregnancy, Infection, and Nutrition study, a prospective pregnancy cohort. Term infants with weight or length measurements at approximately 6 months were included (n = 363). Multivariable regression estimated associations for weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length z-scores (WLZ) and rapid infant weight gain with categorical maternal exposures defined with the 2009 Institute of Medicine recommendations.

RESULTS

Pre-pregnancy overweight and obesity were associated with higher WAZ (linear regression coefficient [β], 0.32; 95% CI, 0.04-0.61) and WLZ (β, 0.39; 95% CI, 0.02-0.76), respectively. Pre-pregnancy BMI was not associated with LAZ. Excessive GWG was associated with higher WAZ (β, 0.39; 95% CI, 0.15-0.62) and LAZ (β, 0.34; 95% CI, 0.12-0.56). Excessive GWG ≥ 200% of recommended amount was associated with higher WAZ (β, 0.68; 95% CI, 0.28-1.07), LAZ (β, 0.45; 95% CI, 0.06-0.83), and WLZ (β, 0.43; 95% CI, 0.04-0.82). Risk of rapid weight gain increased across maternal exposure categories; however, none of the estimates were significant.

CONCLUSIONS

Pre-pregnancy BMI and GWG are modifiable intrauterine exposures that influence infant postnatal anthropometric outcomes. Further investigation with infant body composition measurements is warranted.

摘要

目的

确定孕前体重指数(BMI)和孕期体重增加(GWG)是否会影响婴儿产后生长。

研究设计

参与者来自妊娠、感染和营养研究,这是一项前瞻性妊娠队列研究。将在大约 6 个月时接受体重或长度测量的足月婴儿纳入研究(n=363)。多变量回归估计了体重与年龄比值(WAZ)、长度与年龄比值(LAZ)和体重与长度比值的 Z 分数(WLZ)与快速婴儿体重增加与使用 2009 年医学研究所建议定义的分类产妇暴露的相关性。

结果

孕前超重和肥胖与较高的 WAZ(线性回归系数 [β],0.32;95%置信区间,0.04-0.61)和 WLZ(β,0.39;95%置信区间,0.02-0.76)相关。孕前 BMI 与 LAZ 无关。过多的 GWG 与较高的 WAZ(β,0.39;95%置信区间,0.15-0.62)和 LAZ(β,0.34;95%置信区间,0.12-0.56)相关。过多的 GWG≥推荐量的 200%与较高的 WAZ(β,0.68;95%置信区间,0.28-1.07)、LAZ(β,0.45;95%置信区间,0.06-0.83)和 WLZ(β,0.43;95%置信区间,0.04-0.82)相关。随着产妇暴露类别的增加,快速体重增加的风险也随之增加;然而,这些估计值均无统计学意义。

结论

孕前 BMI 和 GWG 是可改变的宫内暴露因素,会影响婴儿产后的人体测量结果。需要进一步进行婴儿身体成分测量的研究。

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