TMCHC 研究：妊娠体重增加与泌乳始动延迟相关：一项前瞻性队列研究。
Gestational weight gain is associated with delayed onset of lactogenesis in the TMCHC study: A prospective cohort study.
机构信息
Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, China.
Department of Obstetrics and Gynaecology, Hubei Maternal and Child Health Hospital, Wuhan, Hubei, 430070, China.
出版信息
Clin Nutr. 2019 Oct;38(5):2436-2441. doi: 10.1016/j.clnu.2018.11.001. Epub 2018 Nov 20.
BACKGROUND & AIMS: Delayed onset of lactogenesis II (OL) negatively affects breastfeeding and consequently, the health of the newborn. Few studies have examined the association between gestational weight gain (GWG) throughout pregnancy and risk of delayed OL.
METHODS
We used data from a prospective cohort study in Wuhan of China, which enrolled pregnant women at 8-16 weeks of gestation and followed-up regularly. GWG was assessed by the last available weight measurement (LAWM) during pregnancy and the self-reported pre-pregnancy weight at enrollment. The outcome was delayed OL self-reported after 4 days postpartum. Odds ratios (ORs) and 95% confidence intervals (CIs) were derived from multivariate logistic regression.
RESULTS
Delayed OL was reported by 18.4% of the 3282 participants. After adjustment for the demographic, clinical and breastfeeding characteristics, compared to the lowest quartile 1 of GWG, ORs (95% CIs) were 1.20 (0.91, 1.57) for quartile 2, 1.47 (1.13, 1.92) for quartile 3, and 1.42 (1.08, 1.86) for quartile 4 (P for trend = 0.006). When GWG was classified by the 2009 Institute of Medicine (IOM) guidelines, compared with women with adequate GWG, the adjusted ORs (95% CIs) were 0.82 (0.61, 1.10) for inadequate GWG, and 1.13 (0.93, 1.38) for excessive GWG.
CONCLUSIONS
Women with higher GWG throughout pregnancy are more likely to suffer from delayed OL in Chinese population.
背景与目的
II 期泌乳延迟（OL）的发生会对母乳喂养产生负面影响，进而影响新生儿健康。鲜有研究探讨孕期体重增加（GWG）与 OL 延迟风险之间的关系。
方法
我们使用了一项来自中国武汉的前瞻性队列研究的数据，该研究纳入了 8-16 孕周的孕妇，并定期进行随访。GWG 通过孕期最后一次可获得的体重测量值（LAWM）和入组时的自我报告孕前体重进行评估。OL 延迟通过产后 4 天的自我报告进行评估。采用多变量逻辑回归计算比值比（ORs）及其 95%置信区间（CIs）。
结果
3282 名参与者中，有 18.4%报告了 OL 延迟。在校正了人口统计学、临床和母乳喂养特征后，与 GWG 最低四分位 1 相比，四分位 2 的 OR（95%CI）为 1.20（0.91，1.57），四分位 3 的 OR 为 1.47（1.13，1.92），四分位 4 的 OR 为 1.42（1.08，1.86）（趋势 P=0.006）。当 GWG 按照 2009 年美国医学研究所（IOM）指南进行分类时，与 GWG 充足的女性相比，GWG 不足的调整 OR（95%CI）为 0.82（0.61，1.10），GWG 过多的调整 OR 为 1.13（0.93，1.38）。
结论
在中国人群中，孕期 GWG 较高的女性更有可能出现 OL 延迟。
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