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[基于广义估计方程的长沙市开福区产后体重滞留相关因素分析]

[Factors associated with postpartum weight retention based on the generalized estimation equation in Kaifu Districtin Changsha].

作者信息

Li Ling, Yan Yan, Sha Tingting, Gao Xiao, He Qiong, Chen Cheng, Cheng Gang, Wu Xialing, Tian Qianling, Yang Fan, Liu Shiping, Zeng Guangyu, Yan Qiang

机构信息

Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China.

Kaifu District Health Bureau, Changsha 410008, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2019 Jan 28;44(1):59-66. doi: 10.11817/j.issn.1672-7347.2019.01.010.

DOI:10.11817/j.issn.1672-7347.2019.01.010
PMID:30837404
Abstract

To investigate the current status of the postpartum weight retention (PPWR) in Kaifu District of Changsha, and explore the influential factors with PPWR based on the generalized estimating equation model.
 Methods: A cluster sampling method was applied to select women who gave birth at the health service centers of 3 street communities in Kaifu District of Changsha during 2015. According to the inclusion and exclusion criteria, 783 cases were finally included in the study. Data on PPWR were collected prospectively by using the self-made questionnaire at 1, 3, 6 and 8 months after childbirth. Analysis were performed to investigate the associations between PPWR and its potential factors with generalized estimation equation model.
 Results: The mean PPWR of women was gradually decreased with the increase of postpartum time, and 34.6% of them have returned to the pre-pregnancy weight in the 8 months postpartum. Our findings revealed that gestation weight gain (GWG), pre-pregnancy body mass index, feeding patterns, and delivery mode were significantly associated with maternal PPWR (P<0.05). In contrast, maternal age, educational level, per capita income of family, parity and postpartum depression were not contributed to PPWR (P>0.05).
 Conclusion: GWG is one of the most important predictors for PPWR. The key to reducing PPWR is to control GWG systematically. Early targeted interventions and health education should be taken to prevent women from excessive PPWR at the first-year postpartum, in particular to the women who underwent cesarean deliveries and breastfed their infants. It is conducive to reduce the risks of overweight or obesity caused by PPWR.

摘要

为调查长沙市开福区产后体重滞留(PPWR)的现状,并基于广义估计方程模型探讨PPWR的影响因素。方法:采用整群抽样方法,选取2015年在长沙市开福区3个街道社区卫生服务中心分娩的妇女。根据纳入和排除标准,最终783例纳入研究。采用自制问卷在产后1、3、6和8个月前瞻性收集PPWR数据。运用广义估计方程模型分析PPWR与其潜在因素之间的关联。结果:妇女的平均PPWR随产后时间增加而逐渐下降,34.6%的妇女在产后8个月恢复到孕前体重。我们的研究结果显示,孕期体重增加(GWG)、孕前体重指数、喂养方式和分娩方式与产妇PPWR显著相关(P<0.05)。相比之下,产妇年龄、教育水平、家庭人均收入、产次和产后抑郁对PPWR无影响(P>0.05)。结论:GWG是PPWR最重要的预测因素之一。降低PPWR的关键是系统控制GWG。应采取早期针对性干预和健康教育措施,预防妇女在产后第一年出现过度PPWR,尤其是剖宫产和母乳喂养的妇女。这有助于降低PPWR导致超重或肥胖的风险。

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