Department of Medicine, Division of Adolescent Medicine, Children's Hospital Boston, Boston, Massachusetts, USA.
Obesity (Silver Spring). 2011 Oct;19(10):2046-52. doi: 10.1038/oby.2011.25. Epub 2011 Feb 24.
The effect of maternal attempt to lose weight during the postpartum period on later child weight has not been explored. Among 1,044 mother-infant pairs in Project Viva, we estimated longitudinal associations of maternal attempt to lose weight during the postpartum period with child weight and adiposity at age 3 years and examined differences in associations by type of weight loss strategy used. Using covariate-adjusted linear and logistic regression models, we estimated associations before and after adjusting for maternal weight-related variables including prepregnancy BMI. At 6 months postpartum, 53% mothers were trying to lose weight. At age 3 years, mean (s.d.) child BMI z-score was 0.44 (1.01) and 8.9% of children were obese. Children whose mothers were trying to lose weight at 6 months postpartum had higher BMI z-scores (0.30 (95% confidence interval (CI) 0.18, 0.42)) and were more likely to be obese (3.0 (95% CI 1.6, 5.8)) at 3 years of age. Addition of maternal prepregnancy BMI to the models attenuated but did not eliminate the associations seen for BMI z-score (0.24 (95% CI 0.12, 0.36) and obesity (2.4 (95% CI 1.2, 4.7)). Attempting to lose weight by exercising alone was the only weight loss strategy that consistently predicted higher child BMI z-score (0.36 (95% CI 0.14, 0.58)) and odds of obesity (6.0 (95% CI 2.2, 16.5)) at age 3 years. In conclusion, we observed an association between maternal attempt to lose weight at 6 months postpartum, particularly through exercise alone, measured using a single item and child adiposity at age 3 years. This association should be thoroughly examined in future studies.
母亲在产后期间试图减肥对孩子后期体重的影响尚未得到探索。在 Viva 项目的 1044 对母婴中，我们估计了母亲在产后期间试图减肥与孩子 3 岁时体重和肥胖的纵向关联，并检查了使用的减肥策略类型对关联的差异。使用协变量调整的线性和逻辑回归模型，我们在调整包括孕前 BMI 在内的与母亲体重相关的变量之前和之后估计了关联。产后 6 个月时，53%的母亲正在尝试减肥。3 岁时，儿童 BMI z 评分的平均值（标准差）为 0.44（1.01），8.9%的儿童肥胖。产后 6 个月时母亲正在尝试减肥的儿童的 BMI z 评分更高（0.30（95%置信区间（CI）0.18，0.42）），3 岁时肥胖的可能性更大（3.0（95%CI 1.6，5.8））。将母亲的孕前 BMI 添加到模型中减弱了但并未消除 BMI z 评分的关联（0.24（95%CI 0.12，0.36）和肥胖（2.4（95%CI 1.2，4.7））。单独通过运动来减肥是唯一一种始终预测儿童 BMI z 评分更高（0.36（95%CI 0.14，0.58））和肥胖几率更大（6.0（95%CI 2.2，16.5））的减肥策略。总之，我们观察到母亲在产后 6 个月时尝试减肥（特别是单独通过运动）与孩子 3 岁时的肥胖之间存在关联，该关联使用单一项目进行衡量。在未来的研究中，应彻底研究这种关联。
