Chang Tammy, Moniz Michelle H, Plegue Melissa A, Sen Ananda, Davis Matthew M, Villamor Eduardo, Richardson Caroline R
Department of Family Medicine, Medical School, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States of America.
Department of Obstetrics and Gynecology, Medical School, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States of America.
PLoS One. 2017 Mar 14;12(3):e0173790. doi: 10.1371/journal.pone.0173790. eCollection 2017.
Excess weight gain during pregnancy is a serious health concern among young pregnant women in the US. This study aimed to characterize young women at highest risk for gaining over the recommended amount of weight during pregnancy.
Using a database that is representative of births in large U.S. cities, The Fragile Families and Child Wellbeing Study, we identified mothers of singleton term-infants age 15-24 years at the time of delivery. Institute of Medicine guidelines were used to categorize each mother's weight gain as less than, within, or more than recommended during pregnancy. Multinomial logistic regression models for weight gain category were performed, controlling for age, race/ethnicity, federal poverty level (FPL), health status, and prepregnancy BMI.
Among the weighted sample (n = 1,034, N = 181,375), the mean (SD) age was 21 (3) years, 32% were black, 39% were Hispanic, 44% reported income under the Federal Poverty Level, 45% were overweight or obese before pregnancy, and 55% gained more weight than recommended during pregnancy. Women who were overweight or obese before pregnancy were at increased risk for gaining more pregnancy weight than recommended, compared to normal-weight women (adjusted Relative Risk Ratio (RRR) = 3.82, p = 0.01; RRR = 3.27, p = 0.03, respectively). Hispanics were less likely than non-Hispanics to gain more weight than recommended (RRR = 0.39, p = 0.03).
The majority of mothers ages 15-24 gained excess weight during pregnancy, a strong risk factor for later obesity. Prepregnancy overweight or obesity and non-Hispanic ethnicity predicted excess pregnancy weight gain. Interventions and policies should target these high-risk young women to prevent excess weight gain.
孕期体重过度增加是美国年轻孕妇严重的健康问题。本研究旨在确定孕期体重增加超过推荐量风险最高的年轻女性特征。
利用具有美国大城市出生代表性的数据库——脆弱家庭与儿童福利研究，我们确定了分娩时年龄在15 - 24岁的单胎足月儿母亲。采用医学研究所的指南将每位母亲孕期体重增加情况分类为低于、处于或超过推荐量。针对体重增加类别进行多项逻辑回归模型分析，控制年龄、种族/族裔、联邦贫困水平（FPL）、健康状况和孕前体重指数。
在加权样本（n = 1,034，N = 181,375）中，平均（标准差）年龄为21（3）岁，32%为黑人，39%为西班牙裔，44%报告收入低于联邦贫困水平，45%孕前超重或肥胖，55%孕期体重增加超过推荐量。与体重正常的女性相比，孕前超重或肥胖的女性孕期体重增加超过推荐量的风险增加（调整后的相对风险比（RRR）分别为3.82，p = 0.01；RRR = 3.27，p = 0.03）。西班牙裔比非西班牙裔体重增加超过推荐量的可能性更小（RRR = 0.39，p = 0.03）。
15 - 24岁的大多数母亲孕期体重增加过多，这是日后肥胖的一个强大风险因素。孕前超重或肥胖以及非西班牙裔种族预示着孕期体重过度增加。干预措施和政策应针对这些高危年轻女性以防止体重过度增加。
