Epidemiology of gestational weight gain and body weight changes after pregnancy
Epidemiology of gestational weight gain and body weight changes after pregnancy
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DOI：
10.1093/oxfordjournals.epirev.a018038
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发表时间：
2000-01-01
影响因子：
5.5
通讯作者：
Abrams, B
中科院分区：
文献类型：
--
作者：
Gunderson, EP;Abrams, B
女性普遍担心怀孕是否会对她们的体重产生持久影响。对严重肥胖女性的轶事报告和研究指出，怀孕是导致她们肥胖的一个原因。在斯德哥尔摩的一家肥胖诊所中，40-50% 的女性（平均年龄 47.8±10.7 岁）将肥胖的发生归因于生育，73% 的女性报告称怀孕后体重仍保持在 10 公斤 (1, 2)。然而，大多数关于怀孕对产后体重影响的观察性研究的证据并不支持这些看法。对于大多数女性来说，产后 6-18 个月的体重仅比孕前体重增加不超过 1-2 公斤 (3-9)。然而，全国调查中至少有 14-20% 的女性在产后 6-18 个月（3、4、6-8）体重增加了 5 公斤以上。这一证据表明，怀孕可能会大幅增加女性亚群的产后体重，例如妊娠期体重增加较高的女性 (6)。最近的一项研究发现，与未怀孕的女性相比，单次怀孕的女性超重的风险更高 (10)。因此，对平均体重变化的估计并不能反映相当多的女性所经历的体重过度增加；这可能会在随后的怀孕中进一步加剧，并导致肥胖的发生。怀疑影响产后体重的因素包括妊娠期体重增加、妊娠前体重、种族/民族、产次和哺乳期。在肥胖患病率较高的种族/族裔群体中，受孕时的体重可能尤为重要 (8)。过去二十年来，美国女性的平均妊娠期体重增加和超重患病率均有所增加 (8, 11-13)。目前尚不清楚妊娠期体重增加是否是体重增加的部分原因。
Women are universally concerned about whether pregnancy will have a lasting impact on their body weight. Anecdotal reports and studies of severely obese women have pointed to pregnancy as a cause of their obesity. In a Stockholm obesity clinic, 40-50 percent of women (mean age 47.8±10.7 years) attributed the onset of their obesity to childbearing, and 73 percent reported a retention of 10 kg after pregnancy (1, 2). However, most of the evidence from observational studies about the influence of pregnancy on postpartum body weight does not support these perceptions. For the majority of women, body weight at 6-18 months postpartum is no more than 1-2 kg greater than preconceptional weight (3-9). Yet, at least 14-20 percent of women in national surveys were more than 5 kg heavier by 6-18 months postpartum (3, 4, 6-8). This evidence suggests that pregnancy may substantially increase postpartum body weight for subgroups of women, such as those with high gestational weight gain (6). A more recent study found an increased risk of becoming overweight among women who had a single pregnancy compared with nongravid women (10). Thus, estimates of average body weight change do not reflect the excess weight increases experienced by a sizable number of women; this may be further compounded over subsequent pregnancies and contribute to the development of obesity.Factors suspected of influencing postpartum body weight include gestational weight gain, pregravid weight, race/ethnicity, parity, and lactation. Body weight at conception may be particularly important among race/ethnic groups in which the prevalence of obesity is high (8). Both mean gestational weight gain and prevalence of overweight women in the US population have increased over the past two decades (8, 11-13). It has not been established whether increased gestational weight gain is responsible for part of the increasing