一种女性肥胖与生育力的新型系统动力学模型。
A novel system dynamics model of female obesity and fertility.
机构信息
Nasim S. Sabounchi and Peter S. Hovmand are with the Social System Design Lab, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO. Nathaniel D. Osgood is with the Department of Computer Science, University of Saskatchewan, Saskatoon. Roland F. Dyck is with the Department of Medicine, College of Medicine, University of Saskatchewan. Emily S. Jungheim is with the Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO.
出版信息
Am J Public Health. 2014 Jul;104(7):1240-6. doi: 10.2105/AJPH.2014.301898. Epub 2014 May 15.
OBJECTIVES
Our objective was to create a system dynamics model specific to weight gain and obesity in women of reproductive age that could inform future health policies and have the potential for use in preconception interventions targeting obese women.
METHODS
We used our system dynamics model of obesity in women to test various strategies for family building, including ovulation induction versus weight loss to improve ovulation. Outcomes included relative fecundability, postpartum body mass index, and mortality.
RESULTS
Our system dynamics model demonstrated that obese women who become pregnant exhibit increasing obesity levels over time with elevated morbidity and mortality. Alternatively, obese women who lose weight prior to pregnancy have improved reproductive outcomes but may risk an age-related decline in fertility, which can affect overall family size.
CONCLUSIONS
Our model highlights important public health issues regarding obesity in women of reproductive age. The model may be useful in preconception counseling of obese women who are attempting to balance the competing risks associated with age-related declines in fertility and clinically meaningful weight loss.
目的
我们的目标是创建一个专门针对育龄妇女体重增加和肥胖的系统动力学模型，该模型能够为未来的卫生政策提供信息，并有可能用于针对肥胖妇女的孕前干预。
方法
我们使用我们的女性肥胖系统动力学模型来测试各种生育策略，包括诱导排卵与减肥以改善排卵。结果包括相对生育能力、产后体重指数和死亡率。
结果
我们的系统动力学模型表明，怀孕的肥胖女性随着时间的推移肥胖水平不断增加，发病率和死亡率也随之升高。相反，孕前减肥的肥胖女性的生殖结果有所改善，但可能面临与年龄相关的生育能力下降的风险，这可能会影响整体家庭规模。
结论
我们的模型强调了与育龄妇女肥胖相关的重要公共卫生问题。该模型在对试图平衡与年龄相关的生育能力下降和临床上有意义的体重减轻相关的竞争风险的肥胖妇女进行孕前咨询时可能会很有用。
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