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孕期特定阶段体重增加与 5 岁儿童肥胖的关联:来自上海肥胖队列研究的结果。

Association between trimester-specific gestational weight gain and childhood obesity at 5 years of age: results from Shanghai obesity cohort.

机构信息

Department of Clinical Nutrition, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.

Clinical Research Unit, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.

出版信息

BMC Pediatr. 2019 May 2;19(1):139. doi: 10.1186/s12887-019-1517-4.

Abstract

BACKGROUND

It is still unclear if and at which trimester gestational weight gain is related to childhood adiposity. Thus we aimed to evaluate the association between trimester-specific gestational weight gain and body-fat compositions in Chinese children.

METHODS

Maternal gestational weight were measured by trained nurses every 2 to 4 weeks from the first prenatal care, and body-fat compositions of 407 children from the Shanghai Obesity Cohort at 5 years of age were measured by nutritionist through bioelectrical impedance analysis. Overweight/obesity of children was defined according to the criteria of International Obesity Task Force. Logistic and linear regression models adjusted for potential confounders were conducted to evaluate the associations of gestational weight gains with childhood obesity and body-fat compositions. Two-sided P-value < 0.05 was considered statistically significant.

RESULTS

Greater gestational weight gain in the 1-trimester was significantly associated with a higher risk of childhood overweight/obesity [OR: 1.40 (95% CI: 1.06, 1.86)], fat mass index [β: 0.25 (95% CI: 0.12, 0.38)], body fat percentage [β: 1.04 (95% CI: 0.43, 1.65)], and waist-to-height ratio [β: 0.005 (95% CI: 0.002, 0.008)]. A positive but nonsignificant association was found between greater 3-trimester gestational weight gain and a higher risk of offspring overweight/obesity, and we speculated that the association between 2-trimester gestational weight gain and offspring overweight/obesity is the "U" type.

CONCLUSIONS

Weight gain in the first trimester gestation is positively correlated with the risk of childhood overweight/obesity and with body adiposity distributions of children at 5 years of age. Weight gain should be well controlled and monitored from early pregnancy.

摘要

背景

妊娠期体重增加与儿童肥胖的关系尚不清楚,尤其是在哪个孕期与儿童肥胖有关。因此,我们旨在评估中国儿童特定孕期体重增加与体脂肪成分之间的关系。

方法

从第一次产前检查开始,由经过培训的护士每 2 至 4 周测量一次孕妇的妊娠期体重,在 5 岁时,由营养师通过生物电阻抗分析测量 407 名来自上海肥胖队列的儿童的体脂肪成分。根据国际肥胖工作组的标准,将儿童超重/肥胖定义为超重/肥胖。采用调整了潜在混杂因素的逻辑回归和线性回归模型来评估妊娠期体重增加与儿童肥胖和体脂肪成分的相关性。双侧 P 值<0.05 被认为具有统计学意义。

结果

1 孕期体重增加与儿童超重/肥胖的风险增加显著相关[比值比(OR):1.40(95%可信区间:1.06,1.86)],脂肪质量指数(β:0.25(95%可信区间:0.12,0.38)]、体脂肪百分比(β:1.04(95%可信区间:0.43,1.65)]和腰高比(β:0.005(95%可信区间:0.002,0.008)]。3 孕期体重增加与后代超重/肥胖的风险呈正相关,但无统计学意义,我们推测 2 孕期体重增加与后代超重/肥胖的关系呈“U”型。

结论

妊娠早期体重增加与儿童超重/肥胖的风险呈正相关,与 5 岁儿童的体脂肪分布呈正相关。应该从妊娠早期开始,对体重增加进行良好的控制和监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dd2/6495507/638d9a679f60/12887_2019_1517_Fig1_HTML.jpg

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