Risk Factors and Outcomes of Maternal Obesity and Excessive Weight Gain During Pregnancy
Risk Factors and Outcomes of Maternal Obesity and Excessive Weight Gain During Pregnancy
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DOI：
10.1002/oby.20088
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发表时间：
2013-05-01
期刊：
影响因子：
6.9
通讯作者：
Jaddoe, Vincent W. V.
中科院分区：
文献类型：
--
作者：
Gaillard, Romy;Durmus, Busra;Jaddoe, Vincent W. V.
目的：育龄妇女超重和肥胖患病率呈上升趋势。我们的目标是确定母亲肥胖和过度妊娠体重增加的危险因素和母婴和儿童的后果。设计和方法：这项研究嵌入了一项基于人群的前瞻性队列研究，研究对象为6959名母亲和她们的孩子。这项研究是在荷兰鹿特丹进行的(2001-2005)。结果：母亲教育程度低、家庭收入低、多胎和FTO风险等位基因与母亲肥胖的风险增加有关，而母亲的欧洲种族、无胎、总能量摄入量较高和怀孕期间吸烟与妊娠体重过度增加的风险增加相关(所有p值均为0.05)。与正常体重相比，母亲肥胖与妊娠期高血压(OR 6.31(95%CI 4.30，9.26))、先兆子痫(OR(3.61，95%CI 2.04，6.39))、妊娠期糖尿病(OR 6.28(95%CI 3.01，13.06))、剖腹产(OR 1.91(95%CI 1.46，2.50))、胎龄儿过大(OR 2.97(95%CI 2.16，4.08))、儿童肥胖(OR 5.02(95%CI：2.97，8.45))。孕期体重过度增加与母婴和儿童结局的相关性较弱，对妊娠早期体重增加的影响最大。结论：我们的研究表明，母亲肥胖和孕期过度体重增加与社会人口、生活方式和遗传因素有关，并与母亲、胎儿和儿童不良结局的风险增加有关。与孕前超重和肥胖相比，过度妊娠体重增加对不良妊娠结局的影响有限。
Objective: The prevalence of overweight and obesity among women of reproductive age is increasing. We aimed to determine risk factors and maternal, fetal and childhood consequences of maternal obesity and excessive gestational weight gain.Design and Methods: The study was embedded in a population-based prospective cohort study among 6959 mothers and their children. The study was based in Rotterdam, The Netherlands (2001-2005).Results: Maternal lower educational level, lower household income, multiparity, and FTO risk allel were associated with an increased risk of maternal obesity, whereas maternal European ethnicity, nulliparity, higher total energy intake, and smoking during pregnancy were associated with an increased risk of excessive gestational weight gain (all p-values < 0.05). As compared to normal weight, maternal obesity was associated with increased risks of gestational hypertension (OR 6.31 (95% CI 4.30, 9.26)), preeclampsia (OR (3.61, (95% CI 2.04, 6.39)), gestational diabetes (OR 6.28 (95% CI 3.01, 13.06)), caesarean delivery (OR 1.91 (95% CI 1.46, 2.50)), delivering large size for gestational age infants (OR 2.97 (95% CI 2.16, 4.08)), and childhood obesity (OR 5.02 (95% CI: 2.97, 8.45)). Weaker associations of excessive gestational weight gain with maternal, fetal and childhood outcomes were observed, with the strongest effects for first trimester weight gain.Conclusions: Our study shows that maternal obesity and excessive weight gain during pregnancy are associated with socio-demographic, lifestyle, and genetic factors and with increased risks of adverse maternal, fetal and childhood outcomes. As compared to prepregnancy overweight and obesity, excessive gestational weight gain has a limited influence on adverse pregnancy outcomes.