MRC Centre for Causal Analyses in Translational Epidemiology and the School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
Am J Clin Nutr. 2011 Jun;93(6):1285-92. doi: 10.3945/ajcn.110.008326. Epub 2011 Apr 6.
Little is known about associations of gestational weight gain (GWG) with long-term maternal health.
We aimed to examine associations of prepregnancy weight and GWG with maternal body mass index (BMI; in kg/m(2)), waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) 16 y after pregnancy.
This is a prospective study in 2356 mothers from the Avon Longitudinal Study of Parents and Children (ALSPAC)-a population-based pregnancy cohort.
Women with low GWG by Institute of Medicine recommendations had a lower mean BMI (-1.56; 95% CI: -2.12, -1.00) and WC (-3.37 cm; -4.91, -1.83 cm) than did women who gained weight as recommended. Women with a high GWG had a greater mean BMI (2.90; 2.27, 3.52), WC (5.84 cm; 4.15, 7.54 cm), SBP (2.87 mm Hg; 1.22, 4.52 mm Hg), and DBP (1.00 mm Hg; -0.02, 2.01 mm Hg). Analyses were adjusted for age, offspring sex, social class, parity, smoking, physical activity and diet in pregnancy, mode of delivery, and breastfeeding. Women with a high GWG had 3-fold increased odds of overweight and central adiposity. On the basis of estimates from random-effects multilevel models, prepregnancy weight was positively associated with all outcomes. GWG in all stages of pregnancy was positively associated with later BMI, WC, increased odds of overweight or obesity, and central adiposity. GWG in midpregnancy (19-28 wk) was associated with later greater SBP, DBP, and central adiposity but only in women with a normal prepregnancy BMI.
Results support initiatives aimed at optimizing prepregnancy weight. Recommendations on optimal GWG need to balance contrasting associations with different outcomes in both mothers and offspring.
关于妊娠体重增加（GWG）与长期产妇健康之间的关联，人们知之甚少。
我们旨在研究孕前体重和 GWG 与产妇体重指数（BMI；以 kg/m²为单位）、腰围（WC）、收缩压（SBP）和舒张压（DBP）之间的关联，这些关联是在产后 16 年测量的。
这是一项针对阿冯纵向研究父母和儿童（ALSPAC）-一项基于人群的妊娠队列中的 2356 名母亲的前瞻性研究。
根据医学研究所的建议，低 GWG 的女性的平均 BMI（-1.56；95%置信区间：-2.12，-1.00）和 WC（-3.37 cm；-4.91，-1.83 cm）比建议增重的女性低。高 GWG 的女性的平均 BMI（2.90；2.27，3.52）、WC（5.84 cm；4.15，7.54 cm）、SBP（2.87 mm Hg；1.22，4.52 mm Hg）和 DBP（1.00 mm Hg；-0.02，2.01 mm Hg）更大。分析调整了年龄、子女性别、社会阶层、生育次数、吸烟、孕期体力活动和饮食、分娩方式和母乳喂养。高 GWG 的女性超重和中心性肥胖的几率增加了 3 倍。基于随机效应多水平模型的估计，孕前体重与所有结果呈正相关。妊娠各阶段的 GWG 与之后的 BMI、WC、超重或肥胖的几率增加以及中心性肥胖呈正相关。孕中期（19-28 周）的 GWG 与之后更大的 SBP、DBP 和中心性肥胖相关，但仅在 BMI 正常的女性中。
结果支持旨在优化孕前体重的举措。关于最佳 GWG 的建议需要平衡在母亲和后代中不同结果的对比关联。
