Subhan Fatheema Begum, Colman Ian, McCargar Linda, Bell Rhonda C
Department of Agricultural, Food and Nutritional Sciences (Division of Human Nutrition), Alberta Diabetes Institute, University of Alberta, 6-126 Li Ka Shing Centre for Health Research Innovation, Edmonton, AB, T6G 2E1, Canada.
School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, K1H 8M5, Canada.
Matern Child Health J. 2017 Jun;21(6):1396-1407. doi: 10.1007/s10995-016-2246-z.
Objective To describe the effects of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on infant anthropometrics at birth and 3 months and infant growth rates between birth and 3 months. Methods Body weight prior to and during pregnancy and infant weight and length at birth and 3 months were collected from 600 mother-infant pairs. Adherence to GWG was based on IOM recommendations. Age and sex specific z-scores were calculated for infant weight and length at birth and 3 months. Rapid postnatal growth was defined as a difference of >0.67 in weight-for-age z-score between birth and 3 months. Relationships between maternal and infant characteristics were analysed using multilinear regression. Results Most women (65%) had a normal pre-pregnancy BMI and 57% gained above GWG recommendations. Infants were 39.3 ± 1.2 weeks and 3431 ± 447.9 g at birth. At 3 months postpartum 60% were exclusively breast fed while 38% received breast milk and formula. Having a pre-pregnancy BMI >25 kg/m was associated with higher z-scores for birth weight and weight-for-age at 3 months. Gaining above recommendations was associated with higher z-scores for birth weight, weight-for-age and BMI. Infants who experienced rapid postnatal growth had higher odds of being born to women who gained above recommendations. Conclusion for Practice Excessive GWG is associated with higher birth weight and rapid weight gain in infants. Interventions that optimize GWG should explore effects on total and rates of early infant growth.
目的 描述孕前体重指数（BMI）和孕期体重增加（GWG）对婴儿出生时及3个月时人体测量指标以及出生至3个月时婴儿生长速率的影响。方法 收集600对母婴的孕前及孕期体重以及婴儿出生时和3个月时的体重与身长。GWG是否符合要求依据美国医学研究院（IOM）的建议。计算婴儿出生时和3个月时体重和身长的年龄及性别特异性z评分。出生后快速生长定义为出生至3个月时年龄别体重z评分差值>0.67。采用多元线性回归分析母婴特征之间的关系。结果 大多数女性（65%）孕前BMI正常，57%的女性孕期体重增加超过GWG建议值。婴儿出生时孕周为39.3±1.2周，体重为3431±447.9克。产后3个月时，60%的婴儿纯母乳喂养，38%的婴儿接受母乳和配方奶混合喂养。孕前BMI>25kg/m²与出生体重及3个月时年龄别体重的较高z评分相关。孕期体重增加超过建议值与出生体重、年龄别体重及BMI的较高z评分相关。出生后快速生长的婴儿，其母亲孕期体重增加超过建议值的几率更高。实践结论 孕期体重过度增加与婴儿出生体重较高及体重快速增加有关。优化孕期体重增加的干预措施应探讨对婴儿早期总体生长及生长速率的影响。
