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母亲孕前体重轨迹与后代儿童肥胖有关。

Maternal preconception weight trajectories are associated with offsprings' childhood obesity.

机构信息

The University of Queensland, School of Public Health, Centre for Longitudinal and Life Course Research, Herston, Qld, 4006, Australia.

出版信息

Int J Obes (Lond). 2018 Jul;42(7):1265-1274. doi: 10.1038/s41366-018-0078-1. Epub 2018 May 24.

Abstract

OBJECTIVES

This study aimed to examine the associations between (1) mothers' preconception body mass index (BMI) trajectories over 6-7 years and offspring childhood BMI, and (2) mothers' BMI changes between first and second pregnancy and the second-born child's BMI.

METHODS

We used data (1606 mothers with 2733 children with mean age 7.7 years, SD 2.9) from the Australian Longitudinal Study on Women's Health and the Mothers and their Children's Health study. Preconception BMI trajectories were identified using latent class growth modeling. Children were categorized as underweight, normal, overweight or obese based on age and sex-specific BMI cut-off points for children. Multinomial and binary logistic regression were used for analyses.

RESULTS

We identified three preconception BMI trajectories, named as 'normative' (61.2%), 'chronically overweight' (30.7%), and 'chronically obese' (8.1%). Children born to 'chronically overweight' and 'chronically obese' mothers were more likely to be overweight than normal weight relative to children born to women with a 'normative' BMI trajectory. The corresponding adjusted relative risk ratios (RRRs) (95% confidence interval [CI]) of childhood overweight were 1.75 (1.33, 2.31) for chronically overweight mothers and 2.48 (1.65, 3.73) for chronically obese mothers. Similarly, we found a much stronger association between 'chronically overweight' and 'chronically obese' BMI trajectories and childhood risk of obesity; RRR (95% CI), 2.49 (1.41, 4.40) and 6.65 (3.40, 13.01), respectively. Second-born children of mothers with high interpregnancy weight gain (≥4 BMI units) were also at higher risk of being overweight or obese (OR = 2.20, 95% CI: 1.02, 4.75) compared with children of mothers with stable interpregnancy weight (gain or loss of 1 BMI unit or less).

CONCLUSIONS

In this population-based prospective cohort study, we found strong dose-response associations between preconception BMI trajectories and offsprings' childhood BMI.

摘要

目的

本研究旨在探讨(1)母亲在 6-7 年内的孕前体重指数(BMI)轨迹与后代儿童 BMI 之间的关系,以及(2)母亲在第一次和第二次怀孕之间的 BMI 变化与第二胎孩子 BMI 之间的关系。

方法

我们使用了来自澳大利亚女性健康纵向研究和母亲及其子女健康研究的数据(1606 名母亲,2733 名子女,平均年龄 7.7 岁,标准差 2.9)。采用潜在类别增长模型确定孕前 BMI 轨迹。根据儿童年龄和性别特异性 BMI 切点,将儿童分为体重不足、正常、超重或肥胖。采用多项和二项逻辑回归进行分析。

结果

我们确定了三种孕前 BMI 轨迹,分别命名为“正常”(61.2%)、“慢性超重”(30.7%)和“慢性肥胖”(8.1%)。与正常体重的儿童相比,来自“慢性超重”和“慢性肥胖”母亲的儿童更有可能超重。相应的调整后儿童超重的相对风险比(RRR)(95%置信区间[CI])分别为慢性超重母亲的 1.75(1.33,2.31)和慢性肥胖母亲的 2.48(1.65,3.73)。同样,我们发现“慢性超重”和“慢性肥胖”BMI 轨迹与儿童肥胖风险之间存在更强的关联;RRR(95%CI)分别为 2.49(1.41,4.40)和 6.65(3.40,13.01)。与母亲孕期体重稳定(增加或减少 1 BMI 单位或更少)相比,母亲孕期体重增加(≥4 BMI 单位)的第二胎孩子超重或肥胖的风险也更高(OR=2.20,95%CI:1.02,4.75)。

结论

在这项基于人群的前瞻性队列研究中,我们发现孕前 BMI 轨迹与后代儿童 BMI 之间存在很强的剂量反应关系。

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