Wylie Amanda, Sundaram Rajeshwari, Kus Christopher, Ghassabian Akhgar, Yeung Edwina H
Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland, USA; Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Obesity (Silver Spring). 2015 Apr;23(4):907-13. doi: 10.1002/oby.21040. Epub 2015 Mar 7.
Maternal prepregnancy obesity is associated with several poor infant health outcomes; however, studies that investigated motor development have been inconsistent. Thus, maternal prepregnancy weight status and infants' gross motor development were examined.
Participants consisted of 4,901 mother-infant pairs from the Upstate KIDS study, a longitudinal cohort in New York. Mothers indicated dates when infants achieved each of six gross motor milestones when infants were 4, 8, 12, 18, and 24 months old. Failure time modeling under a Weibull distribution was utilized to compare time to achievement across three levels of maternal prepregnancy BMI. Hazard ratios (HR) below one indicate a lower "risk" of achieving the milestone and translate to later achievement.
Compared to infants born to thin and normal-weight mothers (BMI < 25), infants born to mothers with obesity (BMI > 30) were slower to sit without support (HR = 0.91, P = 0.03) and crawl on hands and knees (HR = 0.86, P < 0.001), after adjusting for maternal and birth characteristics. Increased gestational age was associated with faster achievement of all milestones, but additional adjustment did not impact results.
Maternal prepregnancy obesity was associated with a slightly longer time for infant to sit and crawl, potentially due to a compromised intrauterine environment or reduced physically active play.
母亲孕前肥胖与多种不良婴儿健康结局相关；然而，调查运动发育的研究结果并不一致。因此，对母亲孕前体重状况与婴儿的大运动发育进行了研究。
研究对象包括来自纽约上州儿童研究（一项纵向队列研究）的4901对母婴。母亲们指出婴儿在4、8、12、18和24个月大时达到六个大运动里程碑中每个里程碑的日期。采用韦布尔分布下的失效时间模型来比较母亲孕前BMI三个水平下达到各里程碑的时间。低于1的风险比（HR）表明达到该里程碑的“风险”较低，意味着达到时间较晚。
在调整了母亲和出生特征后，与体重过轻和正常体重母亲（BMI＜25）所生的婴儿相比，肥胖母亲（BMI＞30）所生的婴儿在无支撑情况下坐立（HR = 0.91，P = 0.03）和用手和膝盖爬行（HR = 0.86，P＜0.001）的时间更晚。孕周增加与所有里程碑的更快达成相关，但进一步调整并未影响结果。
母亲孕前肥胖与婴儿坐立和爬行时间略长有关，这可能是由于子宫内环境受损或身体活动游戏减少所致。
