Division of Epidemiology, Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-Universität, Munich, Germany.
Obesity (Silver Spring). 2013 Jun;21(6):1232-7. doi: 10.1002/oby.20197. Epub 2013 May 13.
Whether reversal to adequate gestational weight gain (GWG) in the third trimester reverses the risk for childhood overweight associated with excessive GWG is assessed.
In a retrospective cohort study in 6,665 mother-child pairs, pre-pregnancy weight and the temporal course of GWG were collected from medical records. Overweight as defined by International Obesity Task Force was assessed at a mean age of 5.8 years. Main exposures were exceeding week-specific cut-off values for GWG in the third trimester or any previous trimester. Logistic regression models, adjusted for possible confounding factors, were used to predict the risk of childhood overweight from excessive GWG in the third trimester with stratification by excessive GWG in previous trimesters.
In the final model, women who avoided excessive GWG in the third trimester had children with a 31% (odds ratio [OR]: 0.69, 95% confidence interval [CI]: 0.59, 0.82) lower probability being overweight. A similar association was observed for reversing from excessive GWG in the first or second trimester to normal GWG in the third trimester: 27% (OR: 0.73, 95% CI: 0.53, 0.99).
Avoidance of excessive GWG in the third trimester is associated with lower risk of childhood overweight even in case of excessive GWG in the first or second trimester.
评估孕晚期恢复到适当的体重增长(GWG)是否可以降低与 GWG 过多相关的儿童超重风险。
在一项对 6665 对母婴的回顾性队列研究中,从病历中收集了孕妇的孕前体重和 GWG 的时间变化。使用国际肥胖工作组的定义,在平均年龄为 5.8 岁时评估超重情况。主要暴露因素是孕晚期或之前任何一个孕期的 GWG 超过了特定的周界值。使用逻辑回归模型,在考虑了可能的混杂因素后,对孕晚期 GWG 过多与之前各孕期 GWG 过多分层的情况下,预测儿童超重的风险。
在最终模型中,孕晚期避免 GWG 过多的女性,其孩子超重的可能性降低 31%(比值比 [OR]:0.69,95%置信区间 [CI]:0.59,0.82)。对于从孕早期或孕中期 GWG 过多转为孕晚期正常 GWG 的情况,也观察到了类似的关联:降低 27%(OR:0.73,95% CI:0.53,0.99)。
即使在孕早期或孕中期 GWG 过多的情况下,孕晚期避免 GWG 过多也与儿童超重风险降低相关。