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[2013年中国哺乳期女性产后体重滞留状况及其相关因素]

[The status of postpartum weight retention and its associated factors among Chinese lactating women in 2013].

作者信息

Wang J, Yang Z Y, Pang X H, Duan Y F, Jiang S, Zhao L Y, Yin S A, Lai J Q

机构信息

National Institute for Nutrition and Health, Chinese Center for Disease Control and Preventioni; Key Laboratory of Trace Element Nutrition, National Health and Family Planning Commission of the People's Republic of China, Beijing 100050, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2016 Dec 6;50(12):1067-1073. doi: 10.3760/cma.j.issn.0253-9624.2016.12.009.

Abstract

To analyze the status of postpartum weight retention and its associated factors among Chinese lactating women in 2013. This study was based on the databank of in 2013. Using the multi-stage stratified cluster sampling method, we enrolled 12 514 women, at 0-24 months postpartum, from 55 sites in 30 provinces of China (excluding the Tibet Autonomous Region). Questionnaires were used to collect data on basic characteristics, physical activity, lifestyle, food intake, pre-pregnancy weight, weight before delivery, disease history during pregnancy, delivery date, delivery mode, parity and breastfeeding information. Current body weight and height of each subject were measured. Postpartum weight retention in each subject was calculated as the difference between pre-pregnancy and current weights. High postpartum weight retention was defined as ≥5 kg. Survey sample weights were calculated according to the sampling design and number of children under 2 years old from 2010 population census data of China. Associated factors of high postpartum weight retention were identified by multiple logistic regression analysis. A total of 9 972 women were included in this study. (-) of weight retention for participants was 3.6 (0.2-7.3) kg and high weight retention accounted for 41.5% of the subjects (4 134/9 972). The weighted means (SE) of weight retention was 3.5 (0.1) kg, and it was at 0 to <3, 3 to <6, 6 to <9, 9 to <12, 12 to <18 and 18 to <24 months postpartum were 5.3 (0.2), 4.5 (0.2), 3.8 (0.2), 3.1 (0.2), 2.8 (0.2) and 3.0 (0.2) kg, respectively. The weighted proportion of high postpartum weight retention was 37.4% (95% 36.0%-38.9%). Compared with women aged under 25 years old, the odds ratio of high postpartum weight retention was 1.31 for women over 30 years old. Compared with women at 18 to <24 months postpartum, the odds ratio of high postpartum weight retention was 2.67, 1.61 and 1.31 for women at 0 to <3, 3 to <6 and 6 to <9 months postpartum, respectively. Compared with women having a pre-pregnant BMI from 18.5 to <25.0 kg/m, the odds ratio of high postpartum weight retention was 1.30 and 0.67 for women having pre-pregnant BMI <18.5 kg/m and ≥25.0 kg/m, respectively. Compared with women having appropriate gestational weight gain, the odds ratio of high postpartum weight retention was 0.47 and 2.24 for women having low and excessive gestational weight gains, respectively. Compared with farmers, the odds ratio of high postpartum weight retention was 1.44 for housewives. (0.05 for all comparisons). Postpartum weight retention in Chinese lactating women is at an intermediate level. High postpartum weight retention is primarily associated with age, postpartum period, pre-pregnant BMI, gestational weight gain and career. The key control factor for weight retention is gestational weight gain, and 1 year postpartum is critical period for weight recovery.

摘要

分析2013年中国哺乳期妇女产后体重滞留状况及其相关因素。本研究基于2013年的数据库。采用多阶段分层整群抽样方法,我们从中国30个省(不包括西藏自治区)的55个地点纳入了12514名产后0至24个月的妇女。通过问卷调查收集基本特征、身体活动、生活方式、食物摄入、孕前体重、分娩前体重、孕期疾病史、分娩日期、分娩方式、产次和母乳喂养信息。测量每位受试者的当前体重和身高。每位受试者的产后体重滞留量计算为孕前体重与当前体重之差。产后高体重滞留定义为≥5kg。根据抽样设计和2010年中国人口普查数据中2岁以下儿童数量计算调查样本权重。通过多因素logistic回归分析确定产后高体重滞留的相关因素。本研究共纳入9972名妇女。参与者体重滞留的中位数为3.6(0.2 - 7.3)kg,高体重滞留者占受试者的41.5%(4134/9972)。体重滞留的加权均值(标准误)为3.5(0.1)kg,产后0至<3、3至<6、6至<9、9至<12、12至<18和18至<24个月时分别为5.3(0.2)、4.5(0.2)、3.8(0.2)、3.1(0.2)、2.8(0.2)和3.0(0.2)kg。产后高体重滞留的加权比例为37.4%(95% 36.0% - 38.9%)。与25岁以下的妇女相比,30岁以上妇女产后高体重滞留的比值比为1.31。与产后18至<24个月的妇女相比,产后0至<3、3至<6和6至<9个月的妇女产后高体重滞留的比值比分别为2.67、1.61和1.31。与孕前BMI为18.5至<25.0kg/m²的妇女相比,孕前BMI<18.5kg/m²和≥25.0kg/m²的妇女产后高体重滞留的比值比分别为1.30和0.67。与孕期体重增加适宜的妇女相比,孕期体重增加过低和过高的妇女产后高体重滞留的比值比分别为0.47和2.24。与农民相比,家庭主妇产后高体重滞留的比值比为1.44。(所有比较P<0.05)。中国哺乳期妇女产后体重滞留处于中等水平。产后高体重滞留主要与年龄、产后时期、孕前BMI、孕期体重增加和职业有关。体重滞留的关键控制因素是孕期体重增加,产后1年是体重恢复的关键时期。

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