Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
J Nutr. 2020 Jul 1;150(7):1889-1898. doi: 10.1093/jn/nxaa104.
Postpartum weight trajectories and its implications on later cardiometabolic health are not entirely understood.
Our objectives were: 1) to characterize maternal weight trajectories from 1 to 24 mo postpartum, 2) to determine the association of prepregnancy BMI, gestational weight gain (GWG), and pregnancy behaviors with the trajectories, and 3) to evaluate the association of weight trajectories with BMI, waist circumference (WC), lipid profile, glucose, insulin resistance, blood pressure, and inflammatory markers at 3 y postpartum.
We studied 1359 mothers from the prospective cohort Project Viva. Using weights at 1, 6, 12, and 24 mo postpartum, we characterized weight trajectories using a latent class growth model. For objectives 2 and 3, we used multinomial logistic regression and multiple linear regression models, respectively.
Around 85% of women fell into a trajectory of sustained weight loss (1-12 mo) + maintenance (12-24 mo) (reference), 5.7% followed a trajectory characterized by fast weight loss + slight gain, and 9.7% fell into a trajectory of little weight loss + slight gain. Prepregnancy overweight and obesity increased the odds of falling into the fast weight loss + slight gain trajectory, compared with the reference. Prepregnancy overweight [OR 1.57 (95% CI: 1.01, 2.46)] and a higher total GWG rate [3.69 (2.90, 4.68)] increased the odds of falling into the little weight loss + slight gain trajectory, whereas a higher Prudent dietary pattern score was protective [0.73 (0.54, 0.98)]. Women in this trajectory had higher BMI, WC, weight gain from prepregnancy, low-density lipoprotein cholesterol, and inflammatory markers at 3 y postpartum.
Women following a trajectory of little weight loss + slight gain during the first 2 y postpartum had an adverse cardiometabolic profile 3 y after delivery. Targeting diet and GWG during pregnancy and facilitating postpartum weight loss could improve women's long-term health.
产后体重轨迹及其对以后心脏代谢健康的影响尚不完全清楚。
我们的目标是：1）描述产后 1 至 24 个月的产妇体重轨迹，2）确定孕前 BMI、妊娠体重增加（GWG）和妊娠行为与轨迹的关系，3）评估体重轨迹与产后 3 年 BMI、腰围（WC）、血脂谱、血糖、胰岛素抵抗、血压和炎症标志物的关系。
我们研究了前瞻性队列项目 Viva 的 1359 名母亲。使用产后 1、6、12 和 24 个月的体重，我们使用潜在类别增长模型描述体重轨迹。对于目标 2 和 3，我们分别使用多项逻辑回归模型和多元线性回归模型。
约 85%的女性属于持续减重（1-12 个月）+维持（12-24 个月）（参考）、5.7%属于快速减重+轻微增重、9.7%属于减重少+轻微增重轨迹。与参考相比，孕前超重和肥胖增加了归入快速减重+轻微增重轨迹的几率。孕前超重[比值比 1.57（95%置信区间：1.01，2.46）]和较高的总 GWG 率[3.69（2.90，4.68）]增加了归入小体重损失+轻微增重轨迹的几率，而较高的谨慎饮食模式评分具有保护作用[0.73（0.54，0.98）]。处于该轨迹的女性在产后 3 年时 BMI、WC、孕前体重增加、低密度脂蛋白胆固醇和炎症标志物更高。
产后前 2 年体重呈小幅度减轻+轻微增加的女性在产后 3 年时心脏代谢状况较差。在怀孕期间针对饮食和 GWG，并促进产后体重减轻，可能会改善女性的长期健康。
