生育次数对人体成分是否有因果影响：一项出生队列研究。
Is there a causal effect of parity on body composition: a birth cohort study.
机构信息
Postgraduate Programme in Epidemiology, Federal University of Pelotas, Marechal Deodoro, 1160, 3° piso, Centro, Pelotas, Rio Grande do Sul, 96020-220 - Caixa Postal 464, Brazil.
Laboratory of Epidemiology, Federal University of Espírito Santo, Marechal Campos S/N, Santos Dumont, Vitória, Espírito Santo, 29040-091, Brazil.
出版信息
BMC Public Health. 2018 Feb 22;18(1):215. doi: 10.1186/s12889-018-5089-2.
BACKGROUND
Non-communicable diseases are the leading cause of death, worldwide. Obesity is one of the factors that is associated with the development of such diseases. The role of reproductive factors on women body composition has been evaluated, but the findings are controversial. This study was aimed at assessing the association of parity with body composition among women.
METHODS
In 1982, the maternity hospital of Pelotas, a southern Brazilian city, were visited daily and all deliveries were identified. Those livebirths whose family lived in the urban area of the city have been prospectively followed (n = 5914). In 2012-13, we tried to follow the whole cohort, the subjects were interviewed and examined. We evaluated the association of parity with the following body composition variables: body mass index, waist circumference and fat mass %. Estimates were adjusted for family income, skin color, maternal schooling, occupational status, alcohol, smoking, physical activity, and consumption of processed and ultraprocessed foods. All these analyses were replicated among the cohort men as a comparison. We also assessed whether duration of breastfeeding moderated the association.
RESULTS
In the 2012-13 visit, 3701 subjects were evaluated (mean age of 30.2 years). In the present analysis, we included 1620 women and 1653 men. 33% of women were nulliparous and 48% of men were without children. Even after controlling for confounding, parous women had a BMI 0.96 kg/m (95% CI: 0.30; 1.62) higher than nulliparous and for men the regression coefficient was 0.79 kg/m (95% CI: 0.29; 1.29). Waist circumference was also higher among parous women. Among men, the association was not linear and the regression coefficients were lower than that observed among women [3.41 cm (95% CI: -0.91; 7.73) among men and 4.83 cm (95% CI: 2.43; 7.24) among women with more than 3 children when compared with those without children], but this difference was not statistically significant (interaction p value = 0.58). Fat mass % was not associated with parity. Breastfeeding did not modify the association between parity and body composition.
CONCLUSIONS
Parity was positively associated with body mass index and waist circumference among women. However, similar results among men suggest that there is no causal effect of parity.
背景
非传染性疾病是全球范围内导致死亡的主要原因。肥胖是与这些疾病发展相关的因素之一。已经评估了生殖因素对女性身体成分的作用，但研究结果存在争议。本研究旨在评估生育次数与女性身体成分的关系。
方法
1982 年，巴西南里奥格兰德州佩洛塔斯市的妇产医院每天都会进行访问，并确定所有分娩情况。对居住在城市市区的活产婴儿进行前瞻性随访（n=5914）。2012-13 年，我们试图对整个队列进行随访，对受试者进行了访谈和检查。我们评估了生育次数与以下身体成分变量之间的关系：体重指数、腰围和体脂百分比。对家庭收入、肤色、母亲教育程度、职业状况、酒精、吸烟、身体活动以及加工和超加工食品的消费进行了调整。所有这些分析都在男性队列中进行了复制作为比较。我们还评估了母乳喂养时间是否调节了这种关联。
结果
在 2012-13 年的访问中，对 3701 名受试者进行了评估（平均年龄 30.2 岁）。在本分析中，我们纳入了 1620 名女性和 1653 名男性。33%的女性为未生育者，48%的男性没有子女。即使在控制了混杂因素后，生育过的女性的 BMI 比未生育的女性高 0.96kg/m²（95%CI：0.30；1.62），而男性的回归系数为 0.79kg/m²（95%CI：0.29；1.29）。生育过的女性的腰围也更高。对于男性，这种关联并非线性的，回归系数也低于女性[与无子女的男性相比，生育超过 3 个孩子的男性的腰围分别增加 3.41cm（95%CI：-0.91；7.73）和 4.83cm（95%CI：2.43；7.24）]，但这种差异没有统计学意义（交互 p 值=0.58）。体脂百分比与生育次数无关。母乳喂养并没有改变生育次数与身体成分之间的关系。
结论
生育次数与女性的体重指数和腰围呈正相关。然而，男性的相似结果表明生育次数与身体成分之间没有因果关系。
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