Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Great Ormond Street Institute of Child Health, Child and Adolescent Mental Health, Palliative Care and Pediatrics Section, University College London, London, United Kingdom.
Am J Clin Nutr. 2018 Jul 1;108(1):101-107. doi: 10.1093/ajcn/nqy040.
To our knowledge, no previous studies have investigated longitudinal outcomes of maternal loss of control over eating (LOC) in pregnancy in a general population sample.
We aimed to determine whether pregnancy LOC is associated with dietary, gestational weight gain, and offspring birth-weight outcomes in a large population-based prospective study of pregnant women and their children. We also explored the association with offspring weight at age 15.5 y.
Women (n = 11,132) from the Avon Longitudinal Study of Parents and Children (ALSPAC) were included. Crude and adjusted logistic and multinomial regression models were used. LOC in pregnancy and diet at 32 wk of gestation were assessed by self-report. Pregnancy weight gain and birth weight were obtained from obstetric records. Child weight and height were objectively measured at age 15.5 y.
LOC in pregnancy was common (36.3%). Women with pregnancy LOC reported higher total energy intake, consumed more snacks, and had lower vitamin B-6, A, and C intake compared with women without LOC. Women with frequent LOC had lower vitamin B-1 and folate intake [respectively: b = -0.05 (95% CI: -0.07, -0.02) and b = -7.1 (95% CI: -11.8, -2.3) in adjusted analyses], and gained on average 3.74 kg (95% CI: 3.33, 4.13 kg) more than women without LOC. Frequent and occasional LOC were associated with higher birth weight [respectively: b = 0.07 (95% CI: 0.03, 0.1), b = 0.04 (95% CI: 0.02, 0.06)]. Offspring of mothers with frequent pregnancy LOC had 2-fold increased odds of being overweight/obese at 15.5 y [OR = 2.02 (95% CI: 1.37, 3.01)].
Pregnancy LOC eating is common and has an adverse short- and long-term impact on mother and offspring, but has received very limited attention. Our findings further the understanding of risk factors for obesity and highlight a need for improved identification of maternal pregnancy loss of control eating. This trial was registered at clinicaltrials.gov as NCT03269253.
据我们所知，以前没有研究在一般人群样本中调查孕妇失去对饮食的控制（LOC）与纵向结局之间的关系。
我们旨在通过对孕妇及其子女进行的一项大型基于人群的前瞻性研究，确定妊娠 LOC 是否与饮食、妊娠期体重增加和后代出生体重结局相关。我们还探讨了与 15.5 岁后代体重的关系。
纳入了阿冯纵向父母与子女研究（ALSPAC）中的女性（n=11132）。采用未经调整和调整后的逻辑和多项回归模型。通过自我报告评估妊娠期间的 LOC 和 32 周妊娠时的饮食。通过产科记录获得妊娠体重增加和出生体重。在 15.5 岁时，通过客观测量孩子的体重和身高。
妊娠 LOC 较为常见（36.3%）。与没有 LOC 的女性相比，患有妊娠 LOC 的女性报告的总能量摄入更高，食用更多零食，且维生素 B-6、A 和 C 摄入较少。频繁出现 LOC 的女性维生素 B-1 和叶酸的摄入量较低[分别为：调整后分析中的 b=-0.05（95% CI：-0.07，-0.02）和 b=-7.1（95% CI：-11.8，-2.3）]，且比没有 LOC 的女性平均多增重 3.74 公斤（95% CI：3.33，4.13 公斤）。频繁和偶尔出现 LOC 与较高的出生体重相关[分别为：b=0.07（95% CI：0.03，0.1），b=0.04（95% CI：0.02，0.06）]。母亲频繁出现妊娠 LOC 的后代在 15.5 岁时超重/肥胖的可能性增加了两倍[比值比（OR）=2.02（95% CI：1.37，3.01）]。
妊娠 LOC 进食较为常见，对母婴均有短期和长期的不良影响，但受到的关注非常有限。我们的研究结果进一步了解了肥胖的危险因素，并强调了需要更好地识别母亲妊娠期间失去对饮食的控制。本试验在 clinicaltrials.gov 注册，编号为 NCT03269253。
