School of Population Health, University of Queensland, Brisbane, Queensland 4006, Australia.
Nutr Rev. 2013 Jun;71(6):343-52. doi: 10.1111/nure.12034. Epub 2013 May 2.
Gestational weight gain (GWG) is associated with postpartum weight retention (PPWR) in women. The strength of the association between GWG and long-term PPWR and body mass index (BMI), however, is still unclear. Publications from different databases were systematically extracted and the articles relevant to this study were reviewed to quantify the effect estimate of GWG on PPWR and BMI using a bias-adjusted method. The Institute of Medicine categories of "inadequate," "adequate," and "excess" were used to define GWG. The time span for PPWR was divided into three periods (<1 year, 1 year to 9 years, and ≥15 years) to determine outcome at different times postpartum. Twelve studies met the eligibility criteria and were included in the analyses. Women with an inadequate GWG had a significantly lower mean PPWR of -2.14 kg (95%CI, -2.61 to -1.66) than women with an adequate GWG, who had a mean PPWR of 3.15 kg (95%CI, 2.47 to 3.82) up to 21 years postpartum. Over the postpartum time span, a U-shaped relationship was observed between the weighted mean difference calculated for women with excess GWG and the weighted mean difference calculated for women with adequate GWG, and this relationship was time independent between these two groups. Postpartum BMI showed a similar relationship and magnitude of change, but the exact loss or gain was difficult to assess due to fewer studies (n = 5) with considerable heterogeneity of BMI measurements. The findings of this study suggest that GWG outside of the Institute of Medicine recommendations can lead to both short-term and long-term postpartum weight imbalance.
妊娠体重增加（GWG）与女性产后体重滞留（PPWR）有关。然而，GWG 与长期 PPWR 和体重指数（BMI）之间的关联强度仍不清楚。系统地从不同的数据库中提取文献，并对与本研究相关的文章进行综述，以使用偏差调整方法量化 GWG 对 PPWR 和 BMI 的影响估计。使用美国医学研究院（IOM）的“不足”、“适当”和“过多”类别来定义 GWG。PPWR 的时间跨度分为三个时期（<1 年、1 年至 9 年和≥15 年），以确定产后不同时间的结果。符合入选标准的 12 项研究被纳入分析。GWG 不足的女性产后平均 PPWR 明显较低，为-2.14kg（95%CI，-2.61 至-1.66），而 GWG 适当的女性产后平均 PPWR 为 3.15kg（95%CI，2.47 至 3.82），直至产后 21 年。在整个产后期间，观察到 GWG 过多的女性计算的加权平均差异与 GWG 适当的女性计算的加权平均差异之间存在 U 形关系，并且这两组之间的时间独立性。产后 BMI 也显示出类似的关系和变化幅度，但由于研究数量较少（n=5），且 BMI 测量存在较大异质性，因此很难评估确切的损失或增加。本研究的结果表明，超出 IOM 建议的 GWG 可能导致短期和长期产后体重失衡。
