Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Xiangya Road 110, Changsha 410078, China.
Int J Environ Res Public Health. 2019 Nov 15;16(22):4510. doi: 10.3390/ijerph16224510.
There is not much data on the effects of the timing of gestational weight gain (GWG), pre-pregnancy waist circumference (WC), pre-pregnancy body mass index (BMI), and parity, with postpartum weight retention (PPWR) trajectories.
This study was based on a longitudinal cohort. Latent growth mixture models were applied to identify the latent trajectories of PPWR and test the effects of the predictors on distinct classes of PPWR trajectories.
Three PPWR trajectories were identified. About 2.8% ( = 26) of women were classified into Class 1, with an inverted U-shape trajectory; 6.6% ( = 61) were assigned to Class 2, with a rapid increase trajectory; 90.6% ( = 837) were classified into Class 3, with a significant decrease. Women who had a lower pre-pregnancy BMI (β = -0.279), higher pre-pregnancy WC (β = 0.111) and GWG (β = 0.723) were at a higher risk of retaining more weight at 1 month postpartum. Only GWG, especially GWG during late pregnancy, was associated with the rate of PPWR change. Parity was not associated with the changes in PPWR, while, compared to Class 1 trajectory, multiparous women were protected from having a Class 2 trajectory.
Early targeted interventions should be taken to prevent women who were primiparous, and/or had a lower pre-pregnancy BMI and higher pre-pregnancy WC and GWG, from excessive PPWR.
关于妊娠体重增加（GWG）、孕前腰围（WC）、孕前体重指数（BMI）和产次与产后体重滞留（PPWR）轨迹之间的关系，数据并不多。
本研究基于纵向队列。采用潜在增长混合模型来识别 PPWR 的潜在轨迹，并检验预测因子对不同类型的 PPWR 轨迹的影响。
确定了三种 PPWR 轨迹。约 2.8%（=26）的女性被归类为 Class 1，呈倒 U 形轨迹；6.6%（=61）被分配到 Class 2，呈快速增加轨迹；90.6%（=837）被归类为 Class 3，呈显著下降。孕前 BMI 较低（β=-0.279）、孕前 WC 较高（β=0.111）和 GWG 较高（β=0.723）的女性在产后 1 个月时更容易保留更多体重。只有 GWG，尤其是妊娠晚期的 GWG，与 PPWR 变化率相关。产次与 PPWR 的变化无关，而与 Class 1 轨迹相比，多产妇不易发生 Class 2 轨迹。
应采取早期针对性干预措施，防止初产妇和/或孕前 BMI 较低、孕前 WC 和 GWG 较高的女性发生过度的 PPWR。
