母亲肥胖、孕期体重增加与子代肥胖：儿童围产期结局探索性研究
Maternal obesity, gestational weight gain, and offspring adiposity: the exploring perinatal outcomes among children study.
作者信息
Kaar Jill L, Crume Tessa, Brinton John T, Bischoff Kimberly J, McDuffie Robert, Dabelea Dana
机构信息
Department of Pediatrics, Colorado School of Medicine, University of Colorado Denver, Denver, CO.
Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Denver, CO.
出版信息
J Pediatr. 2014 Sep;165(3):509-15. doi: 10.1016/j.jpeds.2014.05.050. Epub 2014 Jul 1.
OBJECTIVE
To determine whether adequate vs excessive gestational weight gain (GWG) attenuated the association between maternal obesity and offspring outcomes.
STUDY DESIGN
Data from 313 mother-child pairs participating in the Exploring Perinatal Outcomes among Children study were used to test this hypothesis. Maternal prepregnancy body mass index (BMI) and weight measures throughout pregnancy were abstracted from electronic medical records. GWG was categorized according to the 2009 Institute of Medicine criteria as adequate or excessive. Offspring outcomes were obtained at a research visit (average age 10.4 years) and included BMI, waist circumference (WC), subcutaneous adipose tissue (SAT) and visceral adipose tissue, high-density lipoprotein cholesterol, and triglyceride levels.
RESULTS
More overweight/obese mothers exceeded the Institute of Medicine GWG recommendations (68%) compared with normal-weight women (50%) (P < .01). Maternal prepregnancy BMI was associated with worse childhood outcomes, particularly among offspring of mothers with excessive GWG (increased BMI [20.34 vs 17.80 kg/m(2)], WC [69.23 vs 62.83 cm], SAT [149.30 vs 90.47 cm(2)], visceral adipose tissue [24.11 vs 17.55 cm(2)], and homeostatic model assessment [52.52 vs 36.69], all P < .001). The effect of maternal prepregnancy BMI on several childhood outcomes was attenuated for offspring of mothers with adequate vs excessive GWG (P < .05 for the interaction between maternal BMI and GWG status on childhood BMI, WC, SAT, and high-density lipoprotein cholesterol).
CONCLUSION
Our findings lend support for pregnancy interventions aiming at controlling GWG to prevent childhood obesity.
目的
确定孕期体重增加（GWG）充足与过度是否会减弱母亲肥胖与子代结局之间的关联。
研究设计
采用参与儿童围产期结局探索研究的313对母婴的数据来检验这一假设。从电子病历中提取母亲孕前体重指数（BMI）和孕期体重测量值。根据2009年医学研究所标准将GWG分类为充足或过度。在一次研究访视（平均年龄10.4岁）时获得子代结局，包括BMI、腰围（WC）、皮下脂肪组织（SAT）和内脏脂肪组织、高密度脂蛋白胆固醇和甘油三酯水平。
结果
与体重正常的女性（50%）相比，更多超重/肥胖母亲超过了医学研究所GWG建议值（68%）（P < 0.01）。母亲孕前BMI与更差的儿童期结局相关，尤其是在GWG过度的母亲的子代中（BMI升高[20.34 vs 17.80 kg/m²]、WC[69.23 vs 62.83 cm]、SAT[149.30 vs 90.47 cm²]、内脏脂肪组织[24.11 vs 17.55 cm²]以及稳态模型评估[52.52 vs 36.69]，所有P < 0.001）。对于GWG充足与过度的母亲的子代，母亲孕前BMI对几种儿童期结局的影响减弱（母亲BMI与GWG状态对儿童BMI、WC、SAT和高密度脂蛋白胆固醇的交互作用P < 0.05）。
结论
我们的研究结果支持旨在控制GWG以预防儿童肥胖的孕期干预措施。
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