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肥胖女性产后体重下降的可改变决定因素:UPBEAT 试验的二次分析。

Modifiable Determinants of Postpartum Weight Loss in Women with Obesity: A Secondary Analysis of the UPBEAT Trial.

机构信息

Department of Women and Children's Health, School of Life Course Sciences, King's College London, London SE1 7EH, UK.

Department of Nutritional Sciences, School of Life Course Sciences, King's College London, London SE1 9NH, UK.

出版信息

Nutrients. 2021 Jun 9;13(6):1979. doi: 10.3390/nu13061979.

Abstract

Pregnancy can alter a woman's weight gain trajectory across the life course and contribute to the development of obesity through retention of weight gained during pregnancy. This study aimed to identify modifiable determinants associated with postpartum weight retention (PPWR; calculated by the difference in pre-pregnancy and 6 month postpartum weight) in 667 women with obesity from the UPBEAT study. We examined the relationship between PPWR and reported glycaemic load, energy intake, and smoking status in pregnancy, excessive gestational weight gain (GWG), mode of delivery, self-reported postpartum physical activity (low, moderate, and high), and mode of infant feeding (breast, formula, and mixed). At the 6 month visit, 48% ( = 320) of women were at or above pre-pregnancy weight. Overall, PPWR was negative (-0.06 kg (-42.0, 40.4)). Breastfeeding for ≥4 months, moderate or high levels of physical activity, and GWG ≤9 kg were associated with negative PPWR. These three determinants were combined to provide a modifiable factor score (range 0-3); for each added variable, a further reduction in PPWR of 3.0 kg (95% confidence interval 3.76, 2.25) occurred compared to women with no modifiable factors. This study identified three additive determinants of PPWR loss. These provide modifiable targets during pregnancy and the postnatal period to enable women with obesity to return to their pre-pregnancy weight.

摘要

妊娠可改变女性一生的体重增加轨迹,并通过保留妊娠期间增加的体重导致肥胖的发生。本研究旨在确定与肥胖的 UPBEAT 研究中的 667 名女性的产后体重滞留(PPWR;通过孕前和产后 6 个月体重的差值计算)相关的可改变决定因素。我们检查了 PPWR 与报告的血糖负荷、妊娠期间的能量摄入和吸烟状况、妊娠期间体重过度增加(GWG)、分娩方式、自我报告的产后体力活动(低、中、高)和婴儿喂养方式(母乳喂养、配方奶喂养和混合喂养)之间的关系。在 6 个月就诊时,48%(=320)的女性体重达到或高于孕前水平。总体而言,PPWR 为负(-0.06 千克(-42.0,40.4))。母乳喂养≥4 个月、中高强度体力活动和 GWG≤9kg 与负的 PPWR 相关。这三个决定因素被组合起来提供了一个可改变的因素评分(范围 0-3);与没有可改变因素的女性相比,每增加一个变量,PPWR 进一步减少 3.0 千克(95%置信区间 3.76,2.25)。本研究确定了产后体重滞留损失的三个附加决定因素。这些为肥胖女性提供了妊娠和产后期间的可改变目标,以使其能够恢复到孕前体重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/508d/8227672/f252d17ee4b1/nutrients-13-01979-g001.jpg

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