Université de Paris Cité, Obstetrical Perinatal and Paediatric Epidemiology Research team (EPOPé), CRESS, INSERM, INRA, Paris, France.
Notre Dame de Bon Secours Maternity Unit, Paris Saint Joseph Hospital, Paris, France.
Eur J Public Health. 2022 Aug 1;32(4):528-534. doi: 10.1093/eurpub/ckac064.
The prevalence of overweight and obesity has increased in various countries. Normal weight before pregnancy is important to protect maternal and newborn health. This study aimed to describe the evolution of body mass index (BMI) before pregnancy in France and explore its association with two measures of socioeconomic status (SES), education and household income.
Data were from four national perinatal surveys in France in 1998, 2003, 2010 and 2016 to describe the time evolution of maternal BMI. We explored the links between BMI and women's characteristics in the most recent period (2010-2016 surveys) since income information was not available before. Risk ratios (RRs) of underweight, overweight and obesity for each measure of SES were computed by using multivariable Poisson regression models.
Overweight and obesity prevalence increased between 1998 and 2016, from 6% to 12% for obesity. Both were inversely associated with SES (higher prevalence among least educated and poorest women), with strong variations for each social indicator, even in multivariable analyses including both. Combining education and income revealed a wide gradient; RR for obesity was 6.01 (95% confidence interval 4.89-7.38) with low education and income <2000 euros/month vs. high education and income ≥4000 euros/month.
Public policies must implement programs to limit the increase in overweight and its unequal distribution in the population, alongside other policies to address the societal determinants of the obesogenic environment. Health professionals need to advise women to improve their eating and physical activity to limit weight gain from childhood to early adulthood.
超重和肥胖的患病率在各国都有所增加。妊娠前的正常体重对于保护母婴健康非常重要。本研究旨在描述法国妊娠前体重指数（BMI）的演变，并探讨其与两种社会经济地位（SES）衡量标准，即教育程度和家庭收入的关系。
本研究数据来自法国四次全国围产期调查，分别在 1998 年、2003 年、2010 年和 2016 年，以描述孕妇 BMI 的时间演变。我们在最近的时期（2010-2016 年的调查）探索了 BMI 与女性特征之间的联系，因为在此之前没有收入信息。利用多变量泊松回归模型，计算了每种 SES 衡量标准下体重过轻、超重和肥胖的风险比（RR）。
1998 年至 2016 年间，超重和肥胖的患病率增加，肥胖的患病率从 6%增加到 12%。两种情况均与 SES 呈负相关（受教育程度最低和收入最低的女性患病率更高），即使在包括两种指标在内的多变量分析中，每个社会指标的变化也很大。将教育程度和收入结合起来显示出广泛的梯度；与高教育程度和收入≥4000 欧元/月相比，低教育程度和收入<2000 欧元/月的女性肥胖 RR 为 6.01（95%置信区间 4.89-7.38）。
公共政策必须实施限制超重增加和其在人群中不平等分布的计划，同时实施其他政策来解决肥胖环境的社会决定因素。卫生专业人员需要建议女性改善饮食和身体活动，以限制从儿童期到成年早期的体重增加。
