Li Run, Liu Dan, Wang Yue, Dai Zhengyan, Zhou Rong, Liu Jing, Zhang Ju, Zeng Guo
Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China.
West China Second Hospital, Shichuan University.
Zhonghua Liu Xing Bing Xue Za Zhi. 2015 Aug;36(8):803-6.
To explore the effect of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on the onset time of lactation (OL).
In this longitudinal study, 751 healthy single pregnant women were selected from three hospitals in Chengdu as subjects of baseline survey during March and September 2013 and were followed before and after delivery, respectively. Finally, data from a total of 473 pregnant women were analyzed. Data on pre-pregnancy weight, delivery mode, birth weight of neonate, information of lactation and maternal demographic characteristics were collected through questionnaire and medical records. Height and weight at the last week before delivery were measured and GWG were calculated. After controlling the potential confounders, a serial of multi-factor ordinal logistic regression models were performed to test the associations between pre-pregnancy BMI, GWG and OL.
The proportions of OL at the < 1, 1-, 24-, 48- and ≥ 72 h groups were 16.3%, 37.0%, 17.5%, 18.6% and 10.6%, respectively. When compared to women with normal weight, the ORs for prolonged OL were 2.85 (1.91-4.27) and 3.42 (1.69-6.90) among pre-pregnant underweight and overweight/obese women, respectively. When compared to women with normal weight and adequate GWG, pre-pregnant underweight women with adequate and excessive GWG showed greater odds of prolonged OL (OR = 2.34, 95% CI: 1.31-4.18; OR = 3.42, 95% CI: 1.67-7.00), respectively. Pre-pregnant overweight/obese women with excessive GWG had increased the odds of prolonged OL (OR = 3.10, 95% CI: 1.15-8.37).
Pre-pregnant BMI appeared an independently factor, associated with OL while GWG might have an effect on OL, when pre-pregnant BMI was considered.
探讨孕前体重指数（BMI）和孕期体重增加（GWG）对泌乳开始时间（OL）的影响。
在这项纵向研究中，2013年3月至9月从成都的三家医院选取751名健康单胎孕妇作为基线调查对象，分别在分娩前后进行随访。最终，对总共473名孕妇的数据进行了分析。通过问卷调查和病历收集孕前体重、分娩方式、新生儿出生体重、泌乳信息和产妇人口统计学特征等数据。测量分娩前最后一周的身高和体重，并计算GWG。在控制潜在混杂因素后，进行一系列多因素有序逻辑回归模型，以检验孕前BMI、GWG与OL之间的关联。
产后<1小时、1小时、24小时、48小时和≥72小时组的OL比例分别为16.3%、37.0%、17.5%、18.6%和10.6%。与体重正常的女性相比，孕前体重过轻和超重/肥胖女性OL延长的OR值分别为2.85（1.91 - 4.27）和3.42（1.69 - 6.90）。与体重正常且GWG适当的女性相比，孕前体重过轻且GWG适当和过多的女性OL延长的几率更高（OR = 2.34，95%CI：1.31 - 4.18；OR = 3.42，95%CI：1.67 - 7.00）。孕前超重/肥胖且GWG过多的女性OL延长的几率增加（OR = 3.10，95%CI：1.15 - 8.37）。
孕前BMI是与OL相关的独立因素，而在考虑孕前BMI时，GWG可能对OL有影响。
