Greater early and mid-pregnancy gestational weight gains are associated with excess adiposity in mid-childhood.
Greater early and mid-pregnancy gestational weight gains are associated with excess adiposity in mid-childhood.
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早期和中期妊娠体重增加与年龄中期的肥胖相关。
DOI：
10.1002/oby.21511
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发表时间：
2016-07
期刊：
影响因子：
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通讯作者：
Oken E
中科院分区：
文献类型：
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作者：
Hivert MF;Rifas-Shiman SL;Gillman MW;Oken E
目前尚不清楚怀孕期间特定时期的妊娠期体重增加（GWG）与儿童肥胖症的关系。我们的目的是评估GWG时间对儿童身体组成的差异影响。在979对来自出生前Viva项目队列的母子中，我们使用临床记录的体重计算了特定于三个月的GWG。结果包括儿童中期的体重指数（BMI）z评分、双重X线吸收法脂肪质量指数（FMI，kg/m2）和无脂肪质量指数（FFMI，kg/m2）。我们使用线性回归模型来评估每个妊娠期的GWG（每0.2 kg/周）与儿童结局的相关性，并对母亲孕前BMI，社会人口统计学变量，生活方式和前三个月的GWG进行了调整。平均（SD）妊娠早期GWG为0.22（0.22）kg/周，妊娠中期为0.49（0.18）kg/周，妊娠晚期为0.47（0.20）kg/周。根据所有指数，妊娠早期GWG较快与BMI z评分较高（0.06单位[95% CI：0.01，0.12]/0.2 kg/周）和肥胖较高相关;孕前BMI> 30 kg/m2的女性相关性最强。妊娠中期GWG较快与BMI z评分（0.11[0.04，0.18]）、脂肪量（FMI=0.16[0.02，0.31] kg/m2）和瘦体重（FFMI=0.11[0.01，0.22] kg/m2）较高相关。妊娠晚期GWG与儿童肥胖无关。这些结果加强了在怀孕早期处理适当的GWG的重要性。
It is unclear how specific periods of gestational weight gain (GWG) during pregnancy relate to childhood adiposity. We aimed to assess the differential impact of GWG timing on childhood body composition. In 979 mother-child pairs from the pre-birth Project Viva cohort, we calculated trimester-specific GWG using clinically recorded weights. Outcomes included body mass index (BMI) z-score, dual X-ray absorptiometry fat mass index (FMI, kg/m2) and fat free mass index (FFMI, kg/m2) in mid-childhood. We used linear regression models to assess associations of each trimester’s GWG (per 0.2 kg/week) with childhood outcomes, adjusted for maternal pre-pregnancy BMI, socio-demographic variables, lifestyle, and GWG in prior trimester(s). Mean (SD) 1st trimester GWG was 0.22(0.22)kg/week, 2nd trimester 0.49(0.18)kg/week, and 3rd trimester 0.47(0.20)kg/week. Faster 1st trimester GWG was associated with higher BMI z-score (0.06 units [95% CI:0.01, 0.12] per 0.2kg/week) and with higher adiposity according to all indices; associations were strongest in women with pre-pregnancy BMI>30kg/m2. Faster 2nd trimester GWG was associated with higher BMI z-score (0.11[0.04, 0.18]), fat mass (FMI=0.16[0.02, 0.31] kg/m2) and also lean mass (FFMI=0.11[0.01, 0.22] kg/m2). 3rd trimester GWG was not associated with childhood adiposity. These results reinforce the importance of addressing appropriate GWG in early pregnancy.