Socioeconomic disparities in prepregnancy BMI and impact on maternal and neonatal outcomes and postpartum weight retention: the EFHL longitudinal birth cohort study
Socioeconomic disparities in prepregnancy BMI and impact on maternal and neonatal outcomes and postpartum weight retention: the EFHL longitudinal birth cohort study
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DOI：
10.1186/1471-2393-14-323
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发表时间：
2014-09-08
影响因子：
3.1
通讯作者：
Scuffham, Paul A.
中科院分区：
文献类型：
--
作者：
Ng, Shu-Kay;Cameron, Cate M.;Scuffham, Paul A.
背景：怀孕后长期肥胖与怀孕前肥胖和产后体重保持有关。本研究旨在确定孕前体重指数的社会经济差异，量化孕前肥胖对出生结果的影响，并确定产后体重保留的决定因素。方法：在产前门诊期间从澳大利亚昆士兰州东南部的三家公立医院招募了总共 2231 名孕妇，完成了一份调查问卷，以获取有关人口统计、社会经济和行为特征的信息。围产期信息是从医院记录中提取的。每位参与者在产后12个月时填写随访问卷，以获得母亲的产后体重、母乳喂养方式、饮食和体力活动特征以及孩子的健康和发育信息。采用多变量逻辑回归方法对孕前肥胖与结局之间的关联进行建模。结果：孕前超重或肥胖与社会经济状况和不良行为因素密切相关。肥胖女性（占队列的 18%）更有可能患妊娠期糖尿病、先兆子痫、剖腹产，她们的孩子更有可能进入重症监护或特殊护理托儿所、胎儿窘迫、复苏和巨大儿。如果女性每天摄入三份或更少的水果/蔬菜、不与婴儿一起参加娱乐活动、每周步行 30 分钟或以上的时间少于一次或每周与朋友相处的时间少于一次，则她们产后体重保持的可能性更大。母乳喂养超过 3 个月的母亲降低了产后体重保持过高的可能性。结论：越来越多的证据表明孕前肥胖易导致孕产妇和围产期不良结局，研究结果提供了额外的特异性。它们可用于采取有效的行为改变干预措施，以解决女性肥胖问题。
Background: Long-term obesity after pregnancy is associated with obesity prior to pregnancy and retention of weight postpartum. This study aims to identify socioeconomic differences in prepregnancy body mass index, quantify the impact of prepregnancy obesity on birth outcomes, and identify determinants of postpartum weight retention.Methods: A total of 2231 pregnant women, recruited from three public hospitals in Southeast Queensland in Australia during antenatal clinic visits, completed a questionnaire to elicit information on demographics, socioeconomic and behavioural characteristics. Perinatal information was extracted from hospital records. A follow-up questionnaire was completed by each participant at 12 months after the birth to obtain the mother's postpartum weight, breastfeeding pattern, dietary and physical activity characteristics, and the child's health and development information. Multivariate logistic regression method was used to model the association between prepregnancy obesity and outcomes.Results: Being overweight or obese prepregnancy was strongly associated with socioeconomic status and adverse behavioural factors. Obese women (18% of the cohort) were more likely to experience gestational diabetes, preeclampsia, cesarean delivery, and their children were more likely to experience intensive-or special-care nursery admission, fetal distress, resuscitation, and macrosomia. Women were more likely to retain weight postpartum if they consumed three or fewer serves of fruit/vegetables per day, did not engage in recreational activity with their baby, spent less than once a week on walking for 30 minutes or more or spent time with friends less than once per week. Mothers who breastfed for more than 3 months had reduced likelihood of high postpartum weight retention.Conclusions: Findings provide additional specificity to the increasing evidence of the predisposition of obesity prepregnancy on adverse maternal and perinatal outcomes. They may be used to target effective behavioural change interventions to address obesity in women.