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母亲妊娠前半期体重增加与 16 岁后代肥胖:一项前瞻性队列研究。

Maternal weight gain during the first half of pregnancy and offspring obesity at 16 years: a prospective cohort study.

机构信息

Finnish Institute of Occupational Health, Oulu, Finland.

出版信息

BJOG. 2012 May;119(6):716-23. doi: 10.1111/j.1471-0528.2012.03319.x.

DOI:10.1111/j.1471-0528.2012.03319.x
PMID:22489762
Abstract

OBJECTIVE

To assess the association between maternal gestational weight gain (GWG) during the first 20 weeks of gestation and overweight/obesity and abdominal obesity of offspring at the age of 16 years.

DESIGN

A prospective cohort study.

SETTING

The two northernmost provinces of Finland.

POPULATION

Mothers and their adolescent offspring born from singleton pregnancies (3265 boys; 3372 girls) in the Northern Finland Birth Cohort 1986.

METHODS

Maternal weight at 20 weeks of gestation was measured in municipal maternity clinics. Maternal GWG was based on the difference between the measured weight and self-reported pre-pregnancy weight, and was classified into quartiles. Offspring weight, height and waist circumference were measured by study nurses during a clinical examination. Logistic regression analyses [with and without adjustment for maternal pre-pregnancy body mass index (BMI), glucose metabolism, education level, haemoglobin, smoking status, parity, and gender of offspring] were performed.

MAIN OUTCOME MEASURE

Offspring overweight/obesity, based on BMI and abdominal obesity at 16 years.

RESULTS

The highest quartile of maternal weight gain (>7.0 kg during the first 20 weeks of gestation) was independently associated with BMI-based overweight/obesity and abdominal obesity in the 16-year-old offspring (OR 1.46, 95% CI 1.16-1.83, and OR 1.37, 95% CI 1.10-1.72, respectively). Among all covariates, maternal pregravid obesity showed the highest odds for both overweight/obesity and abdominal obesity (OR 4.57, 95% CI 3.18-6.57, and OR 4.43, 95% CI 3.10-6.34, respectively).

CONCLUSIONS

Maternal overnutrition during the first half of gestation predicts offspring overweight/obesity and abdominal obesity in adolescence, yet a high pregravid BMI appears to be a more important determinant of both outcomes.

摘要

目的

评估妊娠 20 周前母体体重增加(GWG)与 16 岁后代超重/肥胖和腹部肥胖的关系。

设计

前瞻性队列研究。

地点

芬兰最北部的两个省份。

人群

来自 1986 年芬兰北部出生队列中 3265 名男孩和 3372 名女孩的单胎妊娠母亲及其青少年后代。

方法

在市立妇产科诊所测量妊娠 20 周时的母体体重。母体 GWG 基于测量体重与自我报告的孕前体重之间的差异,并分为四分位。研究护士在临床检查期间测量后代的体重、身高和腰围。进行了逻辑回归分析(包括和不包括调整母体孕前体重指数(BMI)、葡萄糖代谢、教育水平、血红蛋白、吸烟状况、产次和后代性别)。

主要观察指标

16 岁后代的 BMI 为基础的超重/肥胖和腹部肥胖。

结果

妊娠前 20 周体重增加最多的四分位数(>7.0kg)与 16 岁时后代的 BMI 为基础的超重/肥胖和腹部肥胖独立相关(OR 1.46,95%CI 1.16-1.83 和 OR 1.37,95%CI 1.10-1.72)。在所有协变量中,母体妊娠前肥胖对超重/肥胖和腹部肥胖的比值最高(OR 4.57,95%CI 3.18-6.57 和 OR 4.43,95%CI 3.10-6.34)。

结论

妊娠前半期母体营养过剩可预测后代青春期超重/肥胖和腹部肥胖,但孕前 BMI 较高似乎是这两种结果的更重要决定因素。

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