Robinson Whitney R, Cheng Mariah M, Hoggatt Katherine J, Stürmer Til, Siega-Riz Anna M
Department of Epidemiology UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA; Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA.
Obesity (Silver Spring). 2014 Apr;22(4):1126-32. doi: 10.1002/oby.20593. Epub 2013 Sep 20.
Contemporary childbearing is associated with greater gestational weight gain and postpartum weight retention than in previous decades, potentially leading to a more pronounced effect of childbearing on women's long-term obesity risk. Previous work on the association of childbearing with women's long-term obesity risk mostly examined births in the 1970s and 1980s and produced mixed results. The association of childbearing and obesity incidence in a diverse, contemporary sample of 2731 US women was estimated.
Propensity-score (PS) matching was used for confounding control when estimating the effect of incident parity (1996-2001) on 7-year incident obesity (BMI≥30 kg/m(2) ) (2001-2008).
In the sample, 19.3% of parous women became obese, whereas 16.1% of unmatched nulliparous women did. After PS matching without and with replacement, the differences in obesity incidence were, respectively, 0.0 percentage points (ppts) (95% CI: -4.7 to 4.7) and 0.9 ppts (95% CI: -4.9 to 6.7). Results were similar in analyses of prevalent parity and obesity in 2008 (n = 6601) conducted to explore possible selection bias.
These results imply that, in contemporary US parous women in their late 20s and early 30s, childbearing may not increase obesity incidence.
与过去几十年相比，当代生育与孕期体重增加更多及产后体重滞留有关，这可能导致生育对女性长期肥胖风险产生更显著的影响。先前关于生育与女性长期肥胖风险之间关联的研究大多考察的是20世纪70年代和80年代的生育情况，结果不一。本研究估计了2731名美国女性这一多样化当代样本中生育与肥胖发生率之间的关联。
在估计1996 - 2001年的生育次数对2001 - 2008年7年肥胖发生率（体重指数≥30 kg/m²）的影响时，采用倾向得分（PS）匹配法进行混杂因素控制。
在该样本中，19.3%的经产妇肥胖，而未匹配的未产妇肥胖率为16.1%。在不进行替换和进行替换的PS匹配后，肥胖发生率的差异分别为0.0个百分点（ppts）（95%置信区间：-4.7至4.7）和0.9个百分点（95%置信区间：-4.9至6.7）。在对2008年（n = 6601）的现患生育次数和肥胖情况进行分析以探索可能的选择偏倚时，结果相似。
这些结果表明，在当代美国28岁末至30岁初的经产妇中，生育可能不会增加肥胖发生率。
