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妊娠体重增加如何影响产后短期和长期体重滞留?一项更新的系统评价和荟萃分析。

How does gestational weight gain influence short- and long-term postpartum weight retention? An updated systematic review and meta-analysis.

机构信息

Institute of Nutritional Medicine, Else Kröner Fresenius Centre for Nutritional Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.

Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles (UCLA), Los Angeles, California, USA.

出版信息

Obes Rev. 2024 Apr;25(4):e13679. doi: 10.1111/obr.13679. Epub 2024 Jan 14.

Abstract

This systematic review and meta-analysis provide an update of an earlier meta-analysis examining the impact of gestational weight gain (GWG) on postpartum weight retention (PPWR). Thirty-four observational studies were included, and results from 18 studies were combined in meta-analyses. We found that women with excessive GWG retained an additional 2.98 kg (95% CI: 0.59, 5.37 kg, I  = 91%) at 0.5 years, 1.89 kg (95% CI: 0.90, 2.88 kg, I  = 61%) at > 0.5-1 year and 2.89 kg (95% CI: 1.74, 4.04 kg, I  = 0%) at 2-4 years, compared to women who met the National Academy of Medicine GWG recommendations. Moreover, synthesis of confounder-adjusted regression coefficients showed that each 1 kg increase of GWG corresponded to 0.62 kg (95% CI: 0.22, 1.02 kg, I  = 96%) additional PPWR at 6-9 months, 0.48 kg (95% CI: 0.14, 0.81 kg, I  = 93%) at 1-3 years, and 0.31 kg (95% CI: -0.24, 0.86 kg, I  = 89%) at 5-7 years postpartum. Findings suggest that higher GWG contributes to increased maternal body weight in the short- and long-term after childbirth, independent of prepregnancy body mass index. The heterogeneity of reported data and methodological differences across studies complicate the ability to synthesize data and interpret findings.

摘要

本系统评价和荟萃分析更新了先前一项荟萃分析的结果,该分析研究了妊娠体重增加(GWG)对产后体重滞留(PPWR)的影响。共纳入 34 项观察性研究,其中 18 项研究的结果进行了荟萃分析。我们发现,与符合国家医学科学院 GWG 建议的女性相比,GWG 过多的女性在产后 0.5 年时额外保留 2.98 公斤(95%CI:0.59,5.37 公斤,I²=91%),在产后>0.5-1 年时保留 1.89 公斤(95%CI:0.90,2.88 公斤,I²=61%),在产后 2-4 年时保留 2.89 公斤(95%CI:1.74,4.04 公斤,I²=0%)。此外,对混杂因素调整后的回归系数进行综合分析表明,GWG 每增加 1 公斤,产后 6-9 个月时 PPWR 增加 0.62 公斤(95%CI:0.22,1.02 公斤,I²=96%),产后 1-3 年时增加 0.48 公斤(95%CI:0.14,0.81 公斤,I²=93%),产后 5-7 年时增加 0.31 公斤(95%CI:-0.24,0.86 公斤,I²=89%)。这些发现表明,较高的 GWG 会导致产妇产后短期和长期体重增加,与孕前体重指数无关。由于研究间报告数据的异质性和方法学差异,使得综合数据和解释研究结果变得复杂。

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