Josefson J L, Simons H, Zeiss D M, Metzger B E
Division of Endocrinology, Ann & Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Planned Parenthood Federation of America, New York, NY, USA.
J Perinatol. 2016 Dec;36(12):1034-1038. doi: 10.1038/jp.2016.145. Epub 2016 Sep 1.
To assess whether weight gain above or below Institute of Medicine (IOM) recommended amounts in an ethnically diverse obstetric population with normal glucose tolerance is associated with differences in neonatal adiposity.
In this prospective cohort study, healthy women with normal glucose tolerance based on the International Association of Diabetes and Pregnancy Study Groups guidelines were enrolled. Gestational weight at multiple time points were collected. Neonatal adiposity was measured by air displacement plethysmography at 24 to 72 h of life. Analyses included Fisher's exact test, analysis of variance and a trajectory analysis using a group-based weight gain trajectory model with a censored normal distribution.
Overweight and obese women were more likely to exceed IOM weight gain guidelines. Regardless, there was no significant difference in %body fat of neonates born to mothers who either met or exceeded gestational weight gain (GWG) guidelines. GWG timing influenced neonatal anthropometrics: women who gained excessively by the first prenatal visit had neonates with significantly higher birth weight (3.91 vs 3.45 kg, P<0.001) and %body fat (13.7 vs 10.9%, P=0.0001) compared with women who had steady and moderate GWG.
Avoidance of excessive GWG in the first trimester may prevent high amounts of neonatal adiposity.
评估糖耐量正常的不同种族产科人群体重增加高于或低于医学研究所（IOM）推荐量是否与新生儿肥胖差异相关。
在这项前瞻性队列研究中，纳入了根据国际糖尿病与妊娠研究组指南糖耐量正常的健康女性。收集多个时间点的孕期体重。在出生后24至72小时通过空气置换体积描记法测量新生儿肥胖情况。分析包括Fisher精确检验、方差分析以及使用基于分组体重增加轨迹模型和删失正态分布的轨迹分析。
超重和肥胖女性更有可能超过IOM体重增加指南。无论如何，达到或超过孕期体重增加（GWG）指南的母亲所生新生儿的体脂百分比没有显著差异。GWG时间影响新生儿人体测量学：与孕期体重稳定且适中的女性相比，在首次产前检查时体重过度增加的女性所生新生儿的出生体重显著更高（3.91对3.45千克，P<0.001），体脂百分比也更高（13.7对10.9%，P=0.0001）。
在孕早期避免过度的GWG可能预防大量新生儿肥胖。
