Identification of women at risk of adverse weight development following pregnancy
Identification of women at risk of adverse weight development following pregnancy
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DOI：
10.1038/sj.ijo.0803258
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发表时间：
2006-08-01
影响因子：
4.9
通讯作者：
Neovius, M.
中科院分区：
文献类型：
--
作者：
Linne, Y.;Neovius, M.
背景：长期以来，人们都知道怀孕与女性体重问题有关，但除了怀孕期间体重增加外，很少有重要因素被确定。目的：确定怀孕期间体重增加的临界值，以识别怀孕后有高体重潴留风险的妇女。方法：对1984-1985年间分娩的563名妇女进行纵向分析。在1年和15年的随访中，妊娠期间的体重发展被用作高体重保留的诊断测试。高体重保持的真阳性在1年和15年被定义为bbb90百分位数。进行受试者工作特征（ROC）分析，以获得最大限度地减少绝对和相对错误分类数量的截止值。结果：1年（WR1y）和15年（WR15y）的平均体重保持率分别为1.1 +/- 3.6和7.6 +/- 7.4。妊娠期体重增加与随访1年和15年体重保持之间存在中等强度的相关性(r(2) = 0.13和r(2) = 0.05)；WR1y （AUC = 0.76 +/- 0.04, P < 0.01）和WR15y （0.63 +/- 0.04, P < 0.05）作为高固位的诊断指标均优于随机指标。为了尽量减少高体重保持错误分类的绝对数量，需要一个高度特异性和不敏感的截止值，即怀孕期间体重增加约24公斤。灵敏度和特异性之间的最佳权衡，最大限度地减少相对错误分类的数量，是在16公斤左右的截止值，但这导致绝对错误分类的数量是绝对错误分类的三倍。结论：妊娠期体重增加是妊娠后体重保持的一种较强的诊断试验。为了在临床实践中实施体重增加建议，需要进行更大规模的研究，并明确对参考值的要求，因为需要做出关于错误分类类型和程度之间权衡的决定。
Background: It has been known for long time that pregnancy associated with weight problems women but few important factors have been identified, except for weight gain during pregnancy itself.Objective: To identify cutoffs for weight gain during pregnancy for identification of women at risk of high weight retention after pregnancy.Methods: A longitudinal analysis of 563 women who gave birth in 1984-1985 was used. Weight development during pregnancy was used as diagnostic test for high weight retention at 1 and 15 years follow-up. True positives for high weight retention were defined as > 90th percentile at 1 and 15 years. Receiver Operating Characteristic (ROC) analyses were performed to derive cutoffs minimizing the absolute and relative number of misclassifications.Results: The average weight retention at 1 year (WR1y) and 15 years (WR15y) was 1.1 +/- 3.6 and 7.6 +/- 7.4, respectively. There was a moderately strong correlation between weight gain during pregnancy and weight retention at 1 and 15 years follow- up (r(2) = 0.13 and r(2) = 0.05, respectively; both P < 0.001) and weight gain during pregnancy as diagnostic test to find high weight retainers performed better than chance both for WR1y (AUC = 0.76 +/- 0.04, P < 0.01) and WR15y (0.63 +/- 0.04, P < 0.05). To minimize the absolute number of misclassifications of high weight retention, a highly specific and insensitive cut-off of around 24 kg weight gain during pregnancy was needed. The best trade-off between sensitivity and specifity, minimizing the relative number of misclassifications, was at a cutoff of around 16 kg, but this resulted in three times as many absolute misclassifications.Conclusion: Weight gain during pregnancy was found to be a moderately strong diagnostic test for weight retention after pregnancy. In order to implement weight gain recommendations for clinical practice larger studies need to be conducted and the demands on the reference values specified, since decisions about the trade-offs between types and extent of misclassifications need to be made.