epartment of Health. Universidad Iberoamericana.
Center for Nutrition and Health Research. National Institute of Public Health of Mexico.
Nutr Hosp. 2022 Aug 25;39(4):852-862. doi: 10.20960/nh.03999.
Introduction: there is scarce evidence of the effects of obesity and gestational weight- gain (GWG) on hemoglobin (Hb) levels in pregnancy. Little is known about the implications in offspring when pregnant mothers present with both at delivery. Aim: to identify if pre-pregnancy body mass index (BMI) and GWG are associated with Hb levels at pregnancy third trimester; and identify if the BMI status plus anemia at delivery could influence offspring anthropometry. Methods: in a sub-sample of pregnant women (n = 108) and their offspring (n = 63) from a Mexican birth cohort, information from medical files and questionnaires were used to obtain pre-pregnancy BMI (categorized as normal, overweight, and obese), GWG, and Hb during pregnancy; at delivery and postpartum anthropometric measures were obtained for offspring. Adjusted regression models predicted Hb levels according to pre-pregnancy BMI and GWG; offspring growth trajectories from birth to 3 months old were compared according to mother´s BMI status and anemia combinations at delivery. Results: pre-pregnancy normal (N), overweight (OV), and obesity (OB) were present in 48 %, 40 %, and 12 % of the participants, respectively. Anemia was detected in 22.8 % of the participants at third trimester. Hb levels in the third trimester were significantly lower in those with pre-pregnancy OB-BMI and excessive GWG (12.1 g/dL, 95 % CI: 10.7-13.5) compared to those with pre-pregnancy OB-BMI and insufficient GWG (13.3g/dL, 95 %CI: 11.9-14.8) (p = 0.04). At delivery, 11 % presented with OB-BMI and anemia. Women with OB-BMI and normal Hb levels had children with higher scores in Weight-for-Length-Z score and triceps skinfold. Conclusion: among OB women, excessive GWG was associated with having lower Hb levels in the third trimester. Newborns had higher scores in growth patterns related to adiposity from birth to 3 months old if mothers had normal Hb levels and OB.
肥胖和妊娠体重增加（GWG）对妊娠期间血红蛋白（Hb）水平的影响证据很少。当孕妇在分娩时同时存在这两种情况时，对后代的影响知之甚少。目的：确定孕前体重指数（BMI）和 GWG 是否与妊娠晚期 Hb 水平相关；并确定分娩时 BMI 状况加上贫血是否会影响后代的人体测量。方法：在墨西哥出生队列的孕妇（n=108）及其后代（n=63）的子样本中，使用医疗档案和问卷信息获得孕前 BMI（分为正常、超重和肥胖）、GWG 和妊娠期间 Hb；分娩时和产后获得后代的人体测量指标。调整后的回归模型根据孕前 BMI 和 GWG 预测 Hb 水平；根据母亲的 BMI 状况和分娩时的贫血组合，比较后代从出生到 3 个月的生长轨迹。结果：研究对象中分别有 48%、40%和 12%为孕前正常（N）、超重（OV）和肥胖（OB）。第三孕期贫血检出率为 22.8%。与孕前 OB-BMI 和 GWG 不足相比，孕前 OB-BMI 和 GWG 过多的参与者在第三孕期 Hb 水平显著较低（12.1g/dL，95%CI：10.7-13.5）（p=0.04）。分娩时，11%的人出现 OB-BMI 和贫血。OB-BMI 和正常 Hb 水平的女性，其新生儿的体重与身长比评分和三头肌皮褶厚度评分更高。结论：在 OB 女性中，GWG 过多与妊娠晚期 Hb 水平较低有关。如果母亲 Hb 水平正常且为 OB，新生儿从出生到 3 个月的生长模式评分更高，与肥胖有关。
