Bayer Otmar, Ensenauer Regina, Nehring Ina, von Kries Rüdiger
Institute for Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-Universität München, Haydnstr, 5/4, OG, 80336 Munich, Germany.
BMC Pregnancy Childbirth. 2014 Oct 8;14:351. doi: 10.1186/1471-2393-14-351.
Gestational weight gain (GWG) has been shown to be a risk factor for overweight in offspring.Aim of this study was to quantify the contributions of trimester-specific and total GWG on offspring's BMI and waist circumference (WC). This is of interest for the design of interventions targeted at women showing a high GWG in early pregnancy.
In a retrospective cohort study data on GWG (total and by trimester, exposure), a number of potential confounders, and children's BMI z-scores and WC (outcomes) were analyzed using structural equation models to disentangle the trimester-specific direct effects of GWG and indirect effects mediated via total GWG.
7313 mother child pairs with a children's mean age of 5.81 years were analyzed. Total effects (indirect + direct) of GWG (kg/week) on children's BMI z-score and WC (cm) were observed in all trimesters, most prominently in the second. The longitudinal effect of GWG is a composite of trimester-specific direct effects (on BMI: 0.105, 0.255, 0.002, on WC: 0.538, 1.64, 0.308) and total GWG (on BMI 0.608, on WC: 1.03) at the end of pregnancy.
Both trimester-specific priming and total GWG explained offspring's anthropometrics. The results indicate, that reversal from additional weight gain attained early in pregnancy resulting in normal total GWG at the end of pregnancy might still contribute to a substantial reduction of offspring's BMI and WC.
孕期体重增加(GWG)已被证明是后代超重的一个风险因素。本研究的目的是量化孕期特定阶段的GWG和总GWG对后代体重指数(BMI)和腰围(WC)的影响。这对于针对孕早期GWG较高的女性设计干预措施具有重要意义。
在一项回顾性队列研究中,使用结构方程模型分析了GWG(总量及各孕期的量,暴露因素)、一些潜在混杂因素以及儿童BMI z评分和WC(结果)的数据,以厘清孕期特定阶段GWG的直接影响和通过总GWG介导的间接影响。
分析了7313对母婴,儿童平均年龄为5.81岁。在所有孕期均观察到GWG(千克/周)对儿童BMI z评分和WC(厘米)的总体影响(间接+直接),在孕中期最为显著。GWG的纵向影响是孕期特定阶段直接影响(对BMI:0.105、0.255、0.002,对WC:0.538、1.64、0.308)和妊娠末期总GWG(对BMI 0.608,对WC:1.03)的综合结果。
孕期特定阶段的起始影响和总GWG都对后代的人体测量指标有影响。结果表明,在孕早期额外增加的体重在妊娠末期恢复到正常总GWG水平,仍可能对大幅降低后代的BMI和WC有帮助。