Division of Epidemiology, School of Public Health, University of California, 103 Haviland Hall, Berkeley, CA 94720, USA.
Matern Child Health J. 2012 Aug;16(6):1215-23. doi: 10.1007/s10995-011-0846-1.
To investigate associations of trimester-specific GWG with fetal birth size and BMI at age 5 years. We examined 3,015 singleton births to women without pregnancy complications from the Child Health and Development Studies prospective cohort with measured weights during pregnancy. We used multivariable regression to examine the associations between total and trimester gestational weight gain (GWG) and birth weight for gestational age and child BMI outcomes, adjusting for maternal age, race/ethnicity, education, marital status, parity, pre-pregnancy body mass index (BMI), and smoking; paternal overweight, gestational age, and infant sex. We explored differences in associations by maternal BMI and infant sex. GWG in all trimesters was significantly and independently associated with birth weight with associations stronger, though not significantly, in the second trimester. First trimester GWG was associated with child BMI outcomes (OR for child overweight = 1.05; 95% CI = 1.02, 1.09). Each kg of first trimester GWG was significantly associated with increased child BMI z-score in women of low (β = 0.099; 95% CI = 0.034, 0.163) and normal (β = 0.028; 95% CI = 0.012, 0.044), but not high pre-pregnancy BMI. GWG in all trimesters was associated with birth weight; only first trimester GWG was associated with child BMI. If replicated, this information could help specify recommendations for maternal GWG and elucidate mechanisms connecting GWG to child BMI.
研究孕期特定时期体重增加与 5 岁时胎儿出生体重和 BMI 的关系。我们对来自儿童健康与发展研究前瞻性队列的 3015 名无妊娠并发症的单胎分娩妇女进行了检查，这些妇女在孕期有测量体重。我们使用多变量回归来检查总孕期体重增加和孕期各阶段体重增加与出生体重与胎龄比和儿童 BMI 结果之间的关系，调整了母亲的年龄、种族/族裔、教育程度、婚姻状况、产次、孕前体重指数（BMI）和吸烟情况；父亲超重、胎龄和婴儿性别。我们探讨了母亲 BMI 和婴儿性别差异对关联的影响。所有孕期的 GWG 与出生体重显著且独立相关，尽管第二孕期的关联不显著，但更强。第一孕期 GWG 与儿童 BMI 结果相关（超重儿童的 OR = 1.05；95%CI = 1.02，1.09）。在低孕前 BMI（β=0.099；95%CI = 0.034，0.163）和正常孕前 BMI（β=0.028；95%CI = 0.012，0.044）的妇女中，第一孕期 GWG 每增加 1 公斤与儿童 BMI z 评分显著相关，但在高孕前 BMI 的妇女中则无显著相关。所有孕期的 GWG 都与出生体重相关；只有第一孕期 GWG 与儿童 BMI 相关。如果得到证实，这些信息可以帮助明确孕产妇 GWG 的建议，并阐明 GWG 与儿童 BMI 之间的联系机制。
