Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.
Obesity (Silver Spring). 2013 May;21(5):1046-55. doi: 10.1002/oby.20088.
The prevalence of overweight and obesity among women of reproductive age is increasing. We aimed to determine risk factors and maternal, fetal and childhood consequences of maternal obesity and excessive gestational weight gain.
The study was embedded in a population-based prospective cohort study among 6959 mothers and their children. The study was based in Rotterdam, The Netherlands (2001-2005).
Maternal lower educational level, lower household income, multiparity, and FTO risk allel were associated with an increased risk of maternal obesity, whereas maternal European ethnicity, nulliparity, higher total energy intake, and smoking during pregnancy were associated with an increased risk of excessive gestational weight gain (all p-values <0.05). As compared to normal weight, maternal obesity was associated with increased risks of gestational hypertension (OR 6.31 (95% CI 4.30, 9.26)), preeclampsia (OR (3.61, (95% CI 2.04, 6.39)), gestational diabetes (OR 6.28 (95%CI 3.01, 13.06)), caesarean delivery (OR 1.91 (95% CI 1.46, 2.50)), delivering large size for gestational age infants (OR 2.97 (95% CI 2.16, 4.08)), and childhood obesity (OR 5.02 (95% CI:2.97, 8.45)). Weaker associations of excessive gestational weight gain with maternal, fetal and childhood outcomes were observed, with the strongest effects for first trimester weight gain.
Our study shows that maternal obesity and excessive weight gain during pregnancy are associated with socio-demographic, lifestyle, and genetic factors and with increased risks of adverse maternal, fetal and childhood outcomes. As compared to prepregnancy overweight and obesity, excessive gestational weight gain has a limited influence on adverse pregnancy outcomes.
生育年龄妇女超重和肥胖的患病率正在上升。本研究旨在确定肥胖母亲和过多妊娠体重增加的风险因素以及母婴和儿童结局。
本研究纳入了一项基于人群的前瞻性队列研究，共纳入了 6959 名母亲及其子女。该研究在荷兰鹿特丹进行（2001-2005 年）。
母亲的受教育程度较低、家庭收入较低、多胎妊娠和 FTO 风险等位基因与肥胖风险增加相关，而母亲的欧洲种族、初产妇、总能量摄入较高以及孕期吸烟与过多妊娠体重增加的风险增加相关（所有 p 值均<0.05）。与正常体重相比，肥胖母亲发生妊娠高血压的风险增加（OR 6.31（95%CI 4.30，9.26））、子痫前期（OR 3.61（95%CI 2.04，6.39））、妊娠期糖尿病（OR 6.28（95%CI 3.01，13.06））、剖宫产（OR 1.91（95%CI 1.46，2.50））、分娩巨大儿（OR 2.97（95%CI 2.16，4.08））和儿童肥胖（OR 5.02（95%CI：2.97，8.45））的风险增加。我们观察到过多妊娠体重增加与母婴和儿童结局的关联较弱，而与孕早期体重增加的关联最强。
本研究表明，肥胖母亲和妊娠期间体重过度增加与社会人口统计学、生活方式和遗传因素有关，并与母婴和儿童不良结局的风险增加有关。与妊娠前超重和肥胖相比，过多的妊娠体重增加对不良妊娠结局的影响有限。
