Gundersen Lutheran Health System, 1900 South Avenue (NCA1-04), La Crosse, WI 54601, USA.
Matern Child Health J. 2011 Nov;15(8):1166-75. doi: 10.1007/s10995-010-0689-1.
To determine how characteristics of pregnancy, birth, and early infancy are related to offspring obesity at three critical developmental periods. Mothers were followed through pregnancy and 10-15 years after. Offspring data were obtained through medical record review. Maternal and offspring characteristics were examined to predict obesity in childhood (ages 4-5 years), adolescence (ages 9-14 years), and early adulthood (ages 19-20 years). The original cohort included 802 children born to 795 women. Children who were twins, who had died, or whose mothers had died were excluded (n=25). Medical records of 68.5% of the remaining 777 children documented a height and weight at childhood, adolescence, or early adulthood. Relative risks (RRs) to predict obesity at early adulthood were 12.3 for childhood and 45.1 at adolescence. RRs were also significant to predict obesity at early adulthood between the mother's obesity at prepregnancy (RR=6.4), 4-5 years postpregnancy (RR=6.3), and 10-15 years postpregnancy (RR=6.2). Excluding these variables from the multivariate models and adjusting by gender, birth insurance, and mother's marital status at delivery, the best model to predict obesity at childhood included birth weight, weight gain in infancy, and delivery type. At adolescence, it included maternal pregnancy smoking status, gestational weight gain, and weight gain in infancy, and in early adulthood, included maternal pregnancy smoking status, gestational weight gain, and birth weight. Maternal pregnancy smoking status, gestational weight gain, and weight gain in infancy have long-term effects on offspring. Maternal obesity is the strongest predictor of obesity at all times studied.
为了确定妊娠、分娩和婴儿早期的特征与三个关键发育阶段后代肥胖的关系。对母亲进行了妊娠和 10-15 年的随访。通过病历回顾获得了后代数据。检查了母亲和后代的特征，以预测儿童期（4-5 岁）、青春期（9-14 岁）和成年早期（19-20 岁）的肥胖。原始队列包括 795 名女性的 802 名儿童。排除了双胞胎、死亡或母亲死亡的儿童（n=25）。777 名剩余儿童中有 68.5%的儿童病历记录了儿童期、青春期或成年早期的身高和体重。预测成年早期肥胖的相对风险（RR）为儿童期 12.3，青春期 45.1。母亲孕前肥胖（RR=6.4）、产后 4-5 年（RR=6.3）和产后 10-15 年（RR=6.2）时预测成年早期肥胖的 RR 也有显著意义。将这些变量从多变量模型中排除，并通过性别、出生保险和分娩时母亲的婚姻状况进行调整，预测儿童肥胖的最佳模型包括出生体重、婴儿期体重增加和分娩方式。在青春期，它包括母亲孕期吸烟状况、孕期体重增加和婴儿期体重增加，在成年早期，包括母亲孕期吸烟状况、孕期体重增加和出生体重。母亲孕期吸烟状况、孕期体重增加和婴儿期体重增加对后代有长期影响。母亲肥胖是所有研究时期肥胖的最强预测因素。
