Liang J J, Hu Y, Xing Y F, Ma Y, Jiang L, Liu H Y, Hu F, Lu S M, Lin S F
Department of Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2019 Aug 10;40(8):976-981. doi: 10.3760/cma.j.issn.0254-6450.2019.08.019.
To investigate the association of both maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with childhood overweight and adiposity in preschool children. A total of 4 303 preschool children aged 3-5 years were enrolled in our study during June and November 2016 in Guangzhou. Children defined as overweight and obesity were according to the criteria of WHO while weight status during maternal pre-pregnancy was using the China Adult Reference. Gestational weight gain was defined according to the Institute of Medicine guidelines. After adjusting the possible confounding factors, results from the logistic regression analysis showed that both maternal pre-pregnancy overweight and obesity would increase the risk for both childhood overweight and obesity (=1.820, 95: 1.368-2.422). The analysis of covariance results also showed that both maternal overweight and obesity before pregnancy and excessive maternal weight gain during pregnancy increased the BMI -score in children. Maternal GWG over the recommended level were associated with both the childhood overweight and obesity (=1.296, 95: 1.007-1.667). Joint associations of pre-pregnancy BMI and inappropriate GWG were also noticed in the study. Stratified analysis was conducted in three groups according to the pre-pregnancy BMI of the mothers. Result showed that there was no statistical difference in the risks of either overweight or obesity in children (>0.05). However, when compared to mothers with adequate pre-pregnancy higher BMI and adequate GWG, under the combination of high pre-pregnancy BMI and excessive GWG, their adverse effects on childhood overweight and obesity were much higher (=1.574, 95: 1.029-2.409). Both high pre-pregnancy BMI and inappropriate GWG were associated with greater BMI of their offspring. Pregnant women should follow the appropriate weight gain program and help their children to prevent from becoming obese.
探讨孕前体重指数（BMI）和孕期体重增加（GWG）与学龄前儿童超重及肥胖的关联。2016年6月至11月，我们在广州共纳入了4303名3至5岁的学龄前儿童。根据世界卫生组织的标准定义超重和肥胖儿童，而孕前体重状况则采用中国成人参考标准。孕期体重增加根据医学研究所的指南进行定义。在调整可能的混杂因素后，逻辑回归分析结果显示，孕前超重和肥胖均会增加儿童超重和肥胖的风险（比值比=1.820，95%置信区间：1.368-2.422）。协方差分析结果还显示，孕前超重和肥胖以及孕期体重过度增加均会增加儿童的BMI评分。孕期体重增加超过推荐水平与儿童超重和肥胖均相关（比值比=1.296，95%置信区间：1.007-1.667）。研究中还注意到孕前BMI和不适当的孕期体重增加的联合关联。根据母亲的孕前BMI将研究分为三组进行分层分析。结果显示，儿童超重或肥胖风险无统计学差异（P>0.05）。然而，与孕前BMI正常且孕期体重增加适当的母亲相比，在孕前BMI高且孕期体重增加过多的组合下，其对儿童超重和肥胖的不良影响要高得多（比值比=1.574，95%置信区间：1.029-2.409）。孕前BMI高和不适当的孕期体重增加均与后代更高的BMI相关。孕妇应遵循适当的体重增加计划，帮助孩子预防肥胖。
