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孕期早期较高的孕产妇体重指数与泰国年轻成年后代的超重和肥胖有关。

Higher maternal BMI early in pregnancy is associated with overweight and obesity in young adult offspring in Thailand.

作者信息

Ounjaijean Sakaewan, Wongthanee Antika, Kulprachakarn Kanokwan, Rerkasem Amaraporn, Pruenglampoo Sakda, Mangklabruks Ampica, Rerkasem Kittipan, Derraik José G B

机构信息

NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand.

Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

出版信息

BMC Public Health. 2021 Apr 14;21(1):724. doi: 10.1186/s12889-021-10678-z.

Abstract

BACKGROUND

Rates of overweight and obesity among women of reproductive age have been steadily increasing worldwide and in Thailand. There is mounting evidence that maternal obesity during pregnancy is associated with an increased risk of obesity and other adverse health outcomes in the offspring, but such data are lacking for Thailand. We examined the associations between maternal body mass index (BMI) and anthropometry (particularly the likelihood of obesity) and cardiometabolic parameters in young adult offspring.

METHODS

This was a prospective follow-up study of a birth cohort in Chiang Mai (Thailand). Pregnant women carrying singletons were recruited at their first antenatal visit (< 24 weeks of gestation) and followed until delivery in 1989-1990. Participants were their young adult offspring followed up in 2010. Maternal BMI was recorded at the first antenatal visit. The offspring underwent clinical assessments, including anthropometry, lipid profile, insulin sensitivity (HOMA-IR), blood pressure, and carotid intima-media thickness. The primary outcome of interest was the likelihood of obesity in the offspring.

RESULTS

We assessed 628 young adults (54% were females) at 20.6 ± 0.5 years of age (range 19.1-22.1 years). The young adult offspring of mothers with overweight/obesity was 14.1 kg (95%CI 9.7, 18.5; p < 0.0001) and 9.4 kg (95% CI 6.1, 12.8; p < 0.0001) heavier than those born to mothers with underweight or normal weight, respectively, and had BMI 3.46 kg/m (95%CI 2.26, 4.67; p < 0.0001) and 5.27 kg/m (95%CI 3.67, 8.68; p < 0.0001) greater, respectively. For every 1-kg/m increase in maternal BMI, the adjusted odds ratio (aOR) of offspring obesity was 25% greater (95%CI 1.10, 1.42; p < 0.001). Thus, the aOR of obesity in offspring of mothers with overweight/obesity was 4.6 times greater (95%CI 1.86, 11.26; p < 0.001) and nearly 17-fold greater (95%CI 1.96, 146.4; p = 0.010) compared to young adults born to mothers with normal weight or underweight, respectively. There were no observed associations between maternal BMI status and offspring metabolism or blood pressure.

DISCUSSION

Maternal overweight/obesity early in pregnancy was associated with increased BMI and greater odds of obesity in their young adult offspring in Thailand. These findings highlight the public health importance of fostering healthier lifestyle choices among women of reproductive age.

摘要

背景

全球及泰国育龄妇女超重和肥胖率一直在稳步上升。越来越多的证据表明,孕期母亲肥胖与后代肥胖风险及其他不良健康结局增加有关,但泰国缺乏此类数据。我们研究了母亲体重指数(BMI)和人体测量指标(尤其是肥胖可能性)与年轻成年后代心脏代谢参数之间的关联。

方法

这是一项对泰国清迈出生队列的前瞻性随访研究。单胎孕妇在首次产前检查(妊娠<24周)时被招募,并随访至1989 - 1990年分娩。参与者是她们在2010年接受随访的年轻成年后代。首次产前检查时记录母亲的BMI。后代接受临床评估,包括人体测量、血脂谱、胰岛素敏感性(HOMA-IR)、血压和颈动脉内膜中层厚度。主要关注的结局是后代肥胖的可能性。

结果

我们评估了628名平均年龄为20.6±0.5岁(范围19.1 - 22.1岁)的年轻成年人(54%为女性)。超重/肥胖母亲的年轻成年后代比体重过轻或体重正常母亲的后代分别重14.1千克(95%CI 9.7,18.5;p<0.0001)和9.4千克(95%CI 6.1,12.8;p<0.0001),BMI分别高3.46千克/米²(95%CI 2.26,4.67;p<0.0001)和5.27千克/米²(95%CI 3.67,8.68;p<0.0001)。母亲BMI每增加1千克/米²,后代肥胖的调整优势比(aOR)高25%(95%CI 1.10,1.42;p<0.001)。因此,超重/肥胖母亲的后代肥胖的aOR分别比体重正常或体重过轻母亲的年轻成年后代高4.6倍(95%CI 1.86,11.26;p<0.001)和近17倍(95%CI 1.96,14&.4;p = 0.010)。未观察到母亲BMI状态与后代代谢或血压之间的关联。

讨论

泰国孕期早期母亲超重/肥胖与年轻成年后代BMI增加及肥胖几率增大有关。这些发现凸显了在育龄妇女中促进更健康生活方式选择的公共卫生重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8d9/8048216/f1d45d9eac9c/12889_2021_10678_Fig1_HTML.jpg

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