Smith D E, Lewis C E, Caveny J L, Perkins L L, Burke G L, Bild D E
Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine.
JAMA. 1994 Jun 8;271(22):1747-51.
To examine the longitudinal associations between a pregnancy and persistent changes in adiposity in young black and white women.
Prospective cohort study with 5 years of follow-up.
Participants recruited by community-based sampling (Birmingham, Ala; Chicago, Ill; and Minneapolis, Minn) and through the membership of a large prepaid health care plan (Oakland, Calif).
A total of 2788 women (53% black) aged 18 through 30 years were assessed at baseline (1985 through 1986) and reassessed at examination 2 (91% retention; 1987 through 1988) and examination 3 (86% retention; 1990 through 1991). Women who remained nulliparous (n = 925) during the 5-year follow-up were compared with women who had a single pregnancy of 28 weeks' duration during that period and who were at least 12 months postpartum at follow-up (primiparas, n = 89; multiparas, n = 114).
Change in body weight and in waist-to-hip ratio during the 5-year period. Analyses were adjusted for demographic factors (age and education), behavioral variables (smoking and physical activity), and baseline level of adiposity.
Primiparas within both race groups gained 2 to 3 kg more weight during the 5-year period than did nulliparas in both adjusted and unadjusted analyses. Primiparas also had greater increases in waist-to-hip ratio that were independent of weight gain. Multiparas did not differ from nulliparas in adiposity change in either race group. At each level of parity, black women demonstrated greater adverse changes in adiposity than did white women.
These data suggest that women experience modest but adverse increases in body weight and fat distribution after a first pregnancy and that these changes are persistent.
研究年轻黑人和白人女性怀孕与肥胖持续变化之间的纵向关联。
为期5年随访的前瞻性队列研究。
通过社区抽样（阿拉巴马州伯明翰市；伊利诺伊州芝加哥市；明尼苏达州明尼阿波利斯市）以及大型预付医疗保健计划的成员（加利福尼亚州奥克兰市）招募参与者。
共有2788名年龄在18至30岁的女性在基线时（1985年至1986年）接受评估，并在第2次检查时（保留率91%；1987年至1988年）和第3次检查时（保留率86%；1990年至1991年）再次接受评估。将5年随访期间一直未生育的女性（n = 925）与在此期间有一次持续28周妊娠且随访时产后至少12个月的女性进行比较（初产妇，n = 89；经产妇，n = 114）。
5年期间体重和腰臀比的变化。分析对人口统计学因素（年龄和教育程度）、行为变量（吸烟和体育活动）以及肥胖基线水平进行了校正。
在调整和未调整分析中，两个种族组的初产妇在5年期间体重均比未生育女性多增加2至3千克。初产妇的腰臀比增加也更大，且与体重增加无关。两个种族组中，经产妇与未生育女性在肥胖变化方面无差异。在每个生育水平上，黑人女性的肥胖不良变化均比白人女性更大。
这些数据表明，女性在首次怀孕后体重和脂肪分布会出现适度但不良的增加，且这些变化会持续存在。
