School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK.
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Obes Rev. 2020 Nov;21(11):e13048. doi: 10.1111/obr.13048. Epub 2020 May 29.
Causal evidence links modifiable maternal exposures during the periconceptional period with offspring obesity. The interconception period may be an important time to intervene. We systematically identified studies examining change in modifiable maternal exposures between pregnancies and offspring adiposity. We searched for longitudinal studies published between 1990 and 2019, which included measurements taken on at least two occasions in the period from 1 year prior to the conception of the first birth to the time of the second birth, and which included a measure of adiposity in second, or higher order, siblings. Age, ethnicity and genetics were not considered modifiable; all other factors including length of the interpregnancy interval were. Eleven studies satisfied the inclusion criteria. Higher interpregnancy weight gain or loss, maternal smoking inception, mothers smoking in their first pregnancy and quitting, increasing the number of cigarettes smoked and longer interpregnancy intervals were positively associated with adiposity in second or higher order children. Vaginal birth after caesarean delivery was protective. Further research is needed to ascertain whether the risk of adiposity is fixed based on first pregnancy exposures or if interpregnancy change alters the risk for a subsequent child. This can inform the type and effectiveness of interventions for mothers prior to a subsequent pregnancy.
有因果证据表明，围孕期可改变的母体暴露与后代肥胖有关。孕期之间可能是一个重要的干预时期。我们系统地确定了研究孕期之间可改变的母体暴露变化与后代肥胖之间关系的研究。我们搜索了 1990 年至 2019 年期间发表的纵向研究，这些研究包括在第一次怀孕前一年到第二次怀孕时至少两次测量，并且包括对第二次或更高顺序兄弟姐妹的肥胖测量。年龄、种族和遗传不被认为是可改变的；所有其他因素，包括孕期间隔长度都是可改变的。有 11 项研究符合纳入标准。孕期体重增加或减少、母亲开始吸烟、母亲在第一胎中吸烟并戒烟、增加吸烟量和延长孕期间隔与第二胎或更高顺序儿童的肥胖呈正相关。剖宫产术后阴道分娩具有保护作用。需要进一步研究以确定肥胖的风险是基于第一胎暴露固定的，还是孕期之间的变化改变了随后孩子的风险。这可以为母亲在后续怀孕前的干预类型和效果提供信息。
