Lau Erica Y, Liu Junxiu, Archer Edward, McDonald Samantha M, Liu Jihong
Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Room 459 Discovery Building, Columbia, SC 29208, USA.
J Obes. 2014;2014:524939. doi: 10.1155/2014/524939. Epub 2014 Oct 2.
To systematically review the evidence from prospective and retrospective cohort studies on the association between gestational weight gain (GWG) and offspring's body weight.
Electronic databases PubMed, Web of Science, CINAHL, and Academic Search Premiere were searched from inception through March 18, 2013. Included studies (n = 23) were English articles that examined the independent associations of GWG with body mass index (BMI) and/or overweight status in the offspring aged 2 to 18.9 years. Two authors independently extracted the data and assessed methodological quality of the included studies.
Evidence from cohort studies supports that total GWG and exceeding the Institute of Medicine maternal weight gain recommendation were associated with higher BMI z-score and elevated risk of overweight or obesity in offspring. The evidence of high rate of GWG during early- and mid-pregnancy is suggestive. Additionally, the evidence on inadequate GWG and net GWG in relation to body weight outcomes in offspring is insufficient to draw conclusions.
These findings suggest that GWG is a potential risk factor for childhood obesity. However, findings should be interpreted with caution due to measurement issues of GWG and potential confounding effects of shared familial characteristics (i.e., genetics and maternal and child's lifestyle factors).
系统评价前瞻性和回顾性队列研究中关于孕期体重增加(GWG)与子代体重之间关联的证据。
检索电子数据库PubMed、Web of Science、CINAHL和Academic Search Premiere,检索时间从建库至2013年3月18日。纳入的研究(n = 23)为英文文章,研究了GWG与2至18.9岁子代的体重指数(BMI)和/或超重状态之间的独立关联。两位作者独立提取数据并评估纳入研究的方法学质量。
队列研究的证据支持,总的GWG以及超过医学研究所推荐的孕期体重增加量与子代较高的BMI z评分以及超重或肥胖风险升高相关。孕早期和孕中期GWG率较高的证据具有提示性。此外,关于GWG不足以及净GWG与子代体重结局之间关系的证据不足以得出结论。
这些发现表明,GWG是儿童肥胖的一个潜在危险因素。然而,由于GWG的测量问题以及共同家庭特征(即遗传因素以及母婴生活方式因素)的潜在混杂效应,对研究结果的解释应谨慎。