Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.
Am J Obstet Gynecol. 2011 Jan;204(1):52.e1-11. doi: 10.1016/j.ajog.2010.08.028. Epub 2010 Oct 25.
Document weight change trajectories that lead to gestational weight gain or postpartum weight loss outside clinical recommendations established by the Institute of Medicine.
Women aged 14-25 receiving prenatal care and delivering singleton infants at term (n = 427). Medical record review and 4 structured interviews conducted: second and third trimester, 6- and 12-months postpartum. Longitudinal mixed modeling to evaluate weight change trajectories.
Only 22% of participants gained gestational weight within Institute of Medicine guidelines. There were 62% that exceeded maximum recommendations-more common among those overweight/obese (body mass index ≥25.0; P < .0001). 52% retained ≥10 lb 1-year postpartum. Increased weight gain and retention documented among smokers and women with pregnancy-induced hypertension; breastfeeding promoted postpartum weight loss (all P < .02). Body mass index by race interaction suggested healthier outcomes for Latinas (P = .02).
Excessive pregnancy weight gain and inadequate postpartum weight loss are highly prevalent among young low-income ethnic minority women. Pregnancy and postpartum are critical junctures for weight management interventions.
记录导致医学研究所建议的妊娠期体重增加或产后体重减轻以外的体重变化轨迹。
接受产前护理并足月分娩单胎婴儿的 14-25 岁妇女（n=427）。进行了医学记录审查和 4 次结构化访谈：妊娠中期和晚期、产后 6 个月和 12 个月。采用纵向混合模型评估体重变化轨迹。
只有 22%的参与者符合医学研究所的指南，在妊娠期体重增加范围内。有 62%的人超过了最大建议值——超重/肥胖者（体重指数≥25.0；P<.0001）更为常见。52%的人在产后 1 年内保留了≥10 磅的体重。吸烟和患有妊娠高血压的女性体重增加和保留更多；母乳喂养促进产后体重减轻（均 P<.02）。种族间体重指数的相互作用表明拉丁裔的结果更健康（P=.02）。
在年轻的低收入少数民族妇女中，过度妊娠体重增加和产后体重减轻不足非常普遍。妊娠和产后是体重管理干预的关键时期。
