Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
Obesity (Silver Spring). 2012 Jul;20(7):1496-502. doi: 10.1038/oby.2012.41. Epub 2012 Feb 15.
Pregnancy weight gain may lead to long-term increases in maternal BMI for some women. The objective of this study was to examine maternal body weight change 1y-2y postpartum, and to compare classifications of 2y weight retention with and without accounting for 1y-2y weight gain. Early pregnancy body weight (EPW, first trimester) was measured or imputed, and follow-up measures obtained before delivery, 1 year postpartum (1y) and 2 years postpartum (2y) in an observational cohort study of women seeking prenatal care in several counties in upstate New York (n = 413). Baseline height was measured; demographic and behavioral data were obtained from questionnaires and medical records. Associations of 1y-2y weight change (kg) and 1y-2y weight gain (≥2.25 kg) with anthropometric, socioeconomic, and behavioral variables were evaluated using linear and logistic regressions. While mean ± SE 1y-2y weight change was 0.009 ± 4.6 kg, 1y-2y weight gain (≥2.25 kg) was common (n = 108, 26%). Odds of weight gain 1y-2y were higher for overweight (OR(adj) = 2.63, CI(95%) = 1.43-4.82) and obese (OR(adj) = 2.93, CI(95%) = 1.62-5.27) women than for women with BMI <25. Two year weight retention (2y-EPW ≥2.25 kg) was misclassified in 38% (n = 37) of women when 1y-2y weight gain was ignored. One year weight retention (1YWR) (1y-EPW) was negatively related to 1y-2y weight change (β(adj) ± SE = -0.28 ± 0.04, P < 0.001) and weight gain (≥2.25 kg) (OR(adj) = 0.91, CI(95%) = 0.87-0.95). Relations between 1y weight retention and 1y-2y weight change were attenuated for women with higher early pregnancy BMI. Weight change 1y-2y was predicted primarily by an inverse relation with 1y weight retention. The high frequency of weight gain has important implications for classification of postpartum weight retention.
孕期体重增加可能会导致一些女性产后长期体重指数（BMI）增加。本研究的目的是检查产后 1 年至 2 年的产妇体重变化，并比较不考虑和考虑 1 年至 2 年体重增加的 2 年体重保留分类。在一项观察性队列研究中，对在纽约州北部几个县寻求产前护理的妇女（n = 413）在孕早期（第一 trimester）测量或推断其孕前体重（EPW），并在分娩前、产后 1 年（1y）和产后 2 年（2y）获得随访测量值。测量了基线身高；问卷调查和医疗记录获得了人口统计学和行为数据。使用线性和逻辑回归评估 1 年至 2 年体重变化（kg）和 1 年至 2 年体重增加（≥2.25 kg）与人体测量、社会经济和行为变量之间的关联。虽然平均±SE 1 年至 2 年体重变化为 0.009±4.6 kg，但 1 年至 2 年体重增加（≥2.25 kg）很常见（n = 108，26%）。超重（OR（adj）= 2.63，CI（95%）= 1.43-4.82）和肥胖（OR（adj）= 2.93，CI（95%）= 1.62-5.27）女性比 BMI<25 的女性更有可能在 1 年至 2 年内体重增加。当忽略 1 年至 2 年体重增加时，2 年体重保留（2y-EPW≥2.25 kg）在 38%（n = 37）的女性中被错误分类。1 年体重保留（1YWR）（1y-EPW）与 1 年至 2 年体重变化（β（adj）±SE=-0.28±0.04，P<0.001）和体重增加（≥2.25 kg）（OR（adj）=0.91，CI（95%）=0.87-0.95）呈负相关。对于早期妊娠 BMI 较高的女性，1 年体重保留与 1 年至 2 年体重变化之间的关系减弱。1 年至 2 年体重变化主要由与 1 年体重保留的反比关系预测。体重增加的高频率对产后体重保留的分类有重要影响。
