Ronnberg Ann-Kristin, Hanson Ulf, Nilsson Kerstin
Department of Obstetrics and Gynecology, Örebro University, Örebro.
School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Acta Obstet Gynecol Scand. 2017 Sep;96(9):1093-1099. doi: 10.1111/aogs.13168. Epub 2017 Jun 20.
Strategies to limit excessive maternal gestational weight gain could also have positive health effects for the offspring. This study informs us on the effect of an antenatal lifestyle intervention on offspring body mass index (BMI) trajectory until age five.
A secondary analysis of a randomized controlled trial aimed at reducing gestational weight gain, set in Ørebro, Sweden (Clinical Trials.gov Id NCT00451425). Offspring were followed with standardized measures of weight and height until age five. Mean BMI z-score and proportion (%) of over- and undernutrition (BMI z-score > ± 2 standard deviations) was compared between groups. Risk estimates for obesity at age five were analyzed in relation to maternal gestational weight gain and prepregnancy BMI as a secondary outcome.
We analyzed 374 children at birth and 300 at age five. No significant difference in mean BMI z-score was seen at birth (0.68 (I) vs 0.56 (C), p = 0.242) or at age five (0.34 (I) vs 0.26 (C), p = 0.510) and no significant difference in proportion of over- or undernutrition was seen. Excessive maternal gestational weight gain was an independent risk factor for offspring obesity at birth (OR = 4.51, p < 0.001) but not at age five. Maternal obesity was an independent risk factor for offspring obesity at age five (OR = 4.81, p = 0.006).
Our composite antenatal lifestyle intervention did not significantly reduce the risk of obesity in offspring up until age five.
限制孕妇孕期体重过度增加的策略可能对后代健康也有积极影响。本研究告知我们产前生活方式干预对后代五岁前体重指数（BMI）轨迹的影响。
对一项旨在减少孕期体重增加的随机对照试验进行二次分析，该试验在瑞典厄勒布鲁进行（临床试验.gov标识符NCT00451425）。对后代进行体重和身高的标准化测量，直至五岁。比较两组之间的平均BMI z评分以及营养过剩和营养不良的比例（%）（BMI z评分>±2个标准差）。作为次要结果，分析五岁时肥胖的风险估计与孕妇孕期体重增加和孕前BMI的关系。
我们分析了374名出生时的儿童和300名五岁时的儿童。出生时（0.68（干预组）对0.56（对照组），p = 0.242）或五岁时（0.34（干预组）对0.26（对照组），p = 0.510）的平均BMI z评分无显著差异，营养过剩或营养不良的比例也无显著差异。孕妇孕期体重过度增加是后代出生时肥胖的独立危险因素（OR = 4.51，p < 0.001），但五岁时不是。孕妇肥胖是后代五岁时肥胖的独立危险因素（OR = 4.81，p = 0.006）。
我们的综合产前生活方式干预在后代五岁前并未显著降低肥胖风险。
