孕妇孕前体质指数、孕期过度增重与学龄前儿童肥胖关联的出生队列研究  

The association between maternal pre-pregnancy BMI, prenatal excessive weight gain and obesity in preschool children:a birth cohort study

作　　者：付伟男 黄朝辉[1] 郝加虎[1] Fu Weinan;Huang Zhaohui;Hao Jiahu(Dept of Maternal,Child and Adolescent Health,School of Public Health,Anhui Medical University,MOE Key Laboratory of Population Health Across Life Cycle,Hefei 230032)

机构地区：[1]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系(出生人口健康教育部重点实验室),合肥230032

出　　处：《安徽医科大学学报》2021年第1期125-129,165,共6页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:81573164、81872635)。

摘　　要：目的探索孕前BMI、孕期增重对学龄前儿童肥胖测量指标的影响,为孕期妇女体质量管理提供依据。方法选取产检的1 769例孕妇作为研究对象,通过《孕产期母婴健康记录表》与医院电子医疗系统收集孕妇孕前体质指数(BMI)、孕期增重(GWG)等信息,使用《学龄前儿童健康与行为记录表》进行儿童期随访收集学龄前儿童喂养方式、体力活动等信息,体检收集上臂围、上臂皮褶厚度、腹壁皮褶厚度、身高和体质量等身体测量资料,描述相关特征的分布情况及孕前BMI、孕期增重对学龄前儿童肥胖测量指标的影响。结果孕妇GWG过度770例,占50.7%。孕前BMI(χ^(2)=46.08)、家庭年收入(χ^(2)=15.07)、孕次(χ^(2)=12.22)、妊娠意愿(χ^(2)=19.05)不同的孕妇组组间GWG差异有统计学意义(P<0.01)。控制孕妇年龄、文化程度等混杂因素后,孕妇GWG过度与学龄前儿童上臂围(β=0.091,95%CI:0.118~0.505)、上臂皮褶厚厚度(β=0.086,95%CI:0.217~1.067)、腹壁皮褶厚度(β=0.059,95%CI:0.014~0.938)和年龄别BMIZ分(β=0.150,95%CI:0.205~0.456)正相关。孕期BMI消瘦组与学龄前儿童上臂围(β=-0.182,95%CI:-0.896~-0.522)、上臂皮褶厚度(β=-0.138,95%CI:-1.586~-0.758)、腹壁皮褶厚度(β=-0.118,95%CI:-1.563~-0.638)、年龄别BMIZ分(β=-0.182,95%CI:-0.588~-0.342)呈负向相关。结论孕妇GWG过度是学龄前儿童肥胖的危险因素,孕前BMI较低是学龄前儿童肥胖的保护因素。Objective To explore the effects of pre-pregnancy BMI and gestational weight gain on the measure-ment indexes of obesity in preschool children, and provide evidence for weight management of pregnant women. Methods 1 769 pregnant women who underwent prenatal examination in maternal and child health institutions were selected as the study subjects. "Maternal and Child Health record form during pregnancy and delivery period" and the hospital electronic medical system were used to collect information such as pre-pregnancy body mass index(BMI) and gestational weight gain(GWG). The "Health and behavior record of Preschool Children" was used for childhood follow-up to collect information such as physical activity of feeding patterns of preschool children. Physical examination on collected physical measurement data such as upper arm circumference, upper arm skinfold thickness, abdominal wall skinfold thickness, height and weight, and described the distribution of related characteristics and the effects of pre-pregnancy BMI and weight gain during pregnancy on the measurement index of obesity in preschool children. Results The number of pregnant women with excessive GWG are 770, accounting for 50.7%. There were statistically significant differences in Pre-pregnancy BMI(χ^(2)=46.08, P<0.01), annual family income(χ^(2)=15.07), number of pregnancies(χ^(2)=12.22) and different pregnancy attitudes(χ^(2)=19.05) among different GWG groups. After adjusted confounding factors such as education and education, pregnant women with excessive GWG was positively correlated with upper arm circumference of preschool children(β=0.091, 95%CI: 0.118 to 0.505), upper arm skin fold thickness(β=0.086, 95%CI: 0.217 to 1.067), abdominal wall skinfold thickness(β=0.059, 95%CI: 0.014 to 0.938) and age-specific BMI(β=0.150, 95%CI: 0.205 to 0.456). The pre-pregnancy low BMI group and upper arm circumference of preschool children(β=-0.182, 95%CI:-0.896 to-0.522), upper arm skinfold thickness(β=-0.138, 95%CI:-1.586 to-0.758), abdominal wall sk

关 键 词：孕前体质指数 孕期增重 学龄前儿童 肥胖 皮褶厚度 

分 类 号：R179[医药卫生—妇幼卫生保健]