Mariot Márcia Dornelles Machado, Kretzer Daniela Cortés, Becker Patrícia Cemin, Nunes Isadora Musse, Goldani Marcelo Zubaran, Bernardi Juliana Rombaldi, da Silva Clécio Homrich
Center for Child and Adolescent Health Studies, Child and Adolescent Health Graduation Program, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.
Pediatrics Department, Child and Adolescent Health Graduation Program, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.
Matern Child Nutr. 2025 Jan;21(1):e13656. doi: 10.1111/mcn.13656. Epub 2024 Aug 12.
The aim of the current study was to assess the influence of maternal weight gain in different clinical gestational conditions on the child's weight at pre-school age. This was a longitudinal observational study of a prospective and controlled multiple cohort of 372 mother-child pairs with four causal groups of different adverse intrauterine environments (smoking, diabetic, hypertensive and intrauterine growth-restricted pregnant women) and a control group, in the period of, from 2011 to 2016 in three hospitals in Porto Alegre (Brazil). Sociodemographic, prenatal and perinatal data were analysed. Gestational weight gain (GWG) was categorised as 'insufficient', 'adequate' and 'excessive'. The generalised estimation equations (GEE) model was used to assess changes in the z-score of the child's body mass index from birth to pre-school age according to the GWG and gestational group. The child's GWG and weight gain were adjusted for maternal age and education, marital status, family income, pregnancy planning, number of children, prepregnancy BMI, prenatal consultations and type of delivery. A triple interaction effect was observed involving the gestational group, weight gain and study time (p = 0.020) through an adjusted model. Maternal weight gain above the recommended is associated with a significant increase in the child's z - BMI score over time, except for children from pregnant smokers. Children from diabetic mothers , hypertensive mothers and the control group who had a weight gain above that recommended during pregnancy changed their nutritional status from eutrophic to overweight, becoming obese in the DM and hypertension groups and overweight in control. Monitoring of the GWG, especially in the presence of hypertensive diseases and DM, should be effective to prevent children from developing overweight or obesity in pre-school age with an important impact on health conditions in the future.
本研究的目的是评估不同临床妊娠情况下母亲体重增加对学龄前儿童体重的影响。这是一项纵向观察性研究，对372对母婴进行了前瞻性对照多队列研究，分为四个不同不良宫内环境的因果组（吸烟、糖尿病、高血压和宫内生长受限孕妇）和一个对照组，研究时间为2011年至2016年，在巴西阿雷格里港的三家医院进行。分析了社会人口统计学、产前和围产期数据。孕期体重增加（GWG）分为“不足”、“充足”和“过多”。采用广义估计方程（GEE）模型，根据GWG和妊娠组评估儿童出生至学龄前体重指数z评分的变化。对儿童的GWG和体重增加进行了调整，以考虑母亲年龄、教育程度、婚姻状况、家庭收入、妊娠计划、子女数量、孕前BMI、产前检查和分娩方式。通过调整模型观察到妊娠组、体重增加和研究时间之间存在三重交互作用（p = 0.020）。除吸烟孕妇的子女外，母亲体重增加超过推荐值与儿童z - BMI评分随时间显著增加有关。糖尿病母亲、高血压母亲和对照组中孕期体重增加超过推荐值的儿童，其营养状况从营养良好变为超重，糖尿病组和高血压组儿童变为肥胖，对照组儿童变为超重。监测GWG，尤其是在患有高血压疾病和糖尿病的情况下，应能有效预防儿童在学龄前出现超重或肥胖，这对未来的健康状况有重要影响。
