Department of Nutritional Sciences and Toxicology, University of California, Berkeley, California, USA.
Public Health Foundation Enterprises WIC, Irwindale, California, USA.
Matern Child Nutr. 2023 Oct;19(4):e13545. doi: 10.1111/mcn.13545. Epub 2023 Jun 25.
Gaining excessive gestational weight may increase obesity risk in the offspring, while breastfeeding lowers that risk. Using data from the Special Supplemental Nutrition Programme for Women, Infants and Children (WIC) in Southern California, we examined the associations between gestational weight gain (GWG), breastfeeding during infancy and childhood obesity at 2-4 years, and determined whether breastfeeding moderated the association between GWG and childhood obesity. GWG was based on weight measurements collected during the first trimester and within a month before delivery. GWG values were standardized by gestational age (GWG z-scores), per maternal prepregnancy body mass index (BMI) and categorized into tertiles. Fully breastfeeding duration was determined by WIC infant package data indicating the amount of infant formula received monthly. Children's length (or height) and weight measurements were used to calculate BMI-for-age z-scores and identify obesity (z-score ≥ 95th percentile). Multivariable linear and modified Poisson regression analyses were conducted. Fully breastfeeding moderated the association between GWG z-scores tertile and obesity in the offspring. Each additional month of fully breastfeeding was associated with 3%-5% obesity risk reduction for each age group and GWG z-scores tertile, except at age 4 years for children whose mothers had low GWG z-scores (tertile 1). Shorter fully breastfeeding duration was associated with greater obesity risk among children of mothers with high GWG z-scores (tertile 3), but not for those whose mothers had low GWG z-scores. Longer fully breastfeeding duration may provide greater protection against obesity among children at higher risk due to intrauterine exposure to high gestational weight gain.
孕期体重过度增加可能会增加后代肥胖的风险，而母乳喂养则会降低这种风险。本研究利用南加州妇女、婴儿和儿童特别补充营养计划（WIC）的数据，调查了孕期体重增加（GWG）、婴儿期和儿童期母乳喂养与 2-4 岁肥胖之间的关系，并确定了母乳喂养是否调节了 GWG 与儿童肥胖之间的关系。GWG 基于孕早期和分娩前一个月收集的体重测量值。GWG 值按妊娠年龄（GWG z 评分）、产妇孕前体重指数（BMI）进行标准化，并分为三分位。完全母乳喂养的持续时间通过 WIC 婴儿套餐数据确定，该数据表示每月收到的婴儿配方奶粉的数量。儿童的身高和体重测量值用于计算 BMI 年龄 z 评分，并确定肥胖（z 评分≥第 95 个百分位数）。采用多变量线性和修正泊松回归分析。完全母乳喂养调节了 GWG z 评分三分位与后代肥胖之间的关系。与每个年龄组和 GWG z 评分三分位相比，每增加一个月的完全母乳喂养与肥胖风险降低 3%-5%有关，除了 GWG z 评分较低（三分位 1）的母亲的 4 岁儿童外。完全母乳喂养时间较短与 GWG z 评分较高（三分位 3）的母亲的儿童肥胖风险增加有关，但对于 GWG z 评分较低的母亲的儿童则不然。较长时间的完全母乳喂养可能会为因宫内暴露于高 GWG 而处于更高肥胖风险的儿童提供更大的保护。
