生育对妇女体质指数和肥胖发生率的影响

The impact of experience in bearing child on the body mass index and obesity in women

目的本研究利用2002年中国居民营养与健康状况调查数据，分析了不同阶段女性体质指数和肥胖率，以探讨中国成年女性肥胖的预防措施。方法采用多阶段分层整群随机抽样的方法，在全国31个省、自治区、直辖市进行调查。本研究抽取20～30岁育龄女性，分为3组，包括未婚（2474名）、已婚未育（10816名）和已婚生育（4103名）的女性，共计17393名。结果城市未婚女性、已婚未育和已婚生育的女性平均体重分别为（53．7±9．0）kg、（57．6±9．4）kg和（54．5±8．5）k，其中未婚女性、已婚生育女性的平均体重显著高于已婚未育女性（t=12．25，P〈0．0001；t=8．32，P〈0．0001）。城市未婚女性、已婚未育和已婚生育的女性平均体质指数分别为（21．1±3．3）kg／m^2、（22．8±3．4）kg／m^2和（22．0±2．9）kg／m^2，其中已婚未育、已婚生育女性的平均体质指数显著高于未婚女性（t=14．88，P〈0．0001；t=5．76，P〈0．0001）。农村未婚女性、已婚未育和已婚生育的女性平均体重分别为（52．3±7．8）kg、（55．3±8．6）kg和（52．8±8．1）kg，其中未婚女性、已婚生育女性的平均体重显著高于已婚未育女性（t=11．67，P〈0．0001；t=14．15，P〈0．0001）；农村未婚女性、已婚未育和已婚生育的女性平均体质指数分别为（21．2±2．8）kg／m^2、（22．5±3．1）kg／m^2和（21．8±3．0）kg／m^2，其中已婚未育、已婚生育女性的平均体质指数显著高于未婚女性（t=13．80，P〈0．0001；t=5．34，P〈0．0001）；城市未婚女性的低体重率（18．1％）高于已婚未育、已婚生育女性（7．3％和9．1％）（与已婚未育比较χ^2=113．69，P〈0．0001；与已婚生育比较χ^2=29．65，P〈0．0001），而已婚未育女性超重肥胖率（32．7％）显著高于未婚女性（14．4％）（χ^2=28．257，P〈0．0001）。农村未婚女性的低体重率（12．36％）显著高于已婚未育女性（6．73％）（χ^2=50．040，P〈0．0001）；而已婚未育女性超重率（22．4％）显著高于未婚女性（12．3％）和已婚生育女性（15．4％）（与未婚比较χ^2=69．119，P〈0．0001；与已婚生育比较χ^2=69．866，P〈0．0001）；已婚生育女性超重肥胖率随产后时间的延长呈下降趋势。结论已婚生育女性体重滞留是产生成年女性肥胖的重要原因，然而已婚未育女性的体重变化值得重视。

Objective To analyze the relations of body mass index（BMI） and obese prevalence in differently aged women and explore the effective stragety for preventing obesity among adult Chinese women. Method This study was based on the data from 2002 National Nutrition and Health Survey. The method of multi-steps cluster sampling was adopted. Total subjects including unmarried women （ n = 2474）, married women without the experience of childbearing （n = 10 816）, and married and bearing-child women （n =4103）,were 17 393. Results In urban areas, the average body weights of unmarried, married and without childbearing experience, and the married with born-child were （53.7± 9. 0） kg, （57. 6 ± 9.4） kg and （54. 5 ± 8.5）kg respectively;the body weights of unmarried, married and without childbearing experience were significantly higher than that of the married with born-child women （t = 12. 25 ,P 〈0. 001 ; t = 8.32, P 〈0. 001 ） ; the BMIs of unmarried, married without childbearing experience, and the married with bornchild women were （ 21.1 ± 3.3 ） kg/m^2, （ 22. 8 ± 3.4 ） kg/m^2 and （ 22. 0 ± 2. 9 ） kg/m^2 respectively; the BMIs of married without childbearing experience and married with born-child women were significantly higher than that of unmarried women （ t = 14. 88, P 〈 0. 001 ; t = 5.76, P 〈 0. 001 ）. In the rural areas, the body weights of unmarried, married without childbearing experience, and the married with born-child women were （52. 3 ± 7. 8） kg, （ 55.3 ± 8. 6 ） kg and （ 52. 8 ± 8. 1 ） kg respectively ; the body weights of unmarried, the married with born-child women were significantly higher than that of married without childbearing experience （t = 11.67, P 〈 0. 001 ; t = 14. 15, P 〈 0. 001 ） ; the BMIs of unmarried, married without childbearing experience,and the married with born-child women were （ 21.2 ± 2. 8 ） kg/m^2, （ 22. 5 ± 3.1 ） kg/m^2, and （21.8 ± 3. 0） kg/m^2 respectively; the BMIs of married and the married with born-child were significantly higher than that of unmarried women （t = 13.80, P 〈 0. 001 ;t = 5.34, P 〈 0. 001 ）. In urban areas, the rate of low body weight of unmarried women （18.1%） was higher than that of married without childbearing experience and married with born-child group （7.3% vs. 9. 1%; comparing with married without childbearing experience ： χ^2 = 113.69, P 〈 0. 001 ; comparing with married with born-child ： χ^2 = 29. 65, P 〈 0. 001 ） ; the prevalence of overweight and obesity（ 32. 7% ） in married without childbearing was significantly higher than that of unmarried women （ 14. 4% ） （ χ^2 = 28. 257, P 〈 0. 001 ）. In rural areas, the rate of low body weight of unmarried women （ 12.4% ） was higher than that of married without childbearing group （6. 7% ,X2 =50. 040,P 〈0. 001 ） ; however,the prevalence of overweight （22.4%） in the married without childbearing was significantly higher than that of unmarried women （12. 3% ） （χ^2 = 69. 119 ,P 〈 0. 001 ） and the married with born-child women（ 15.4% ） （ χ^2 = 69. 866, P 〈 0. 001 ）. The prevalence of overweight and obesity of the married with born-child women was decreasing with extending time of postpartum in urban and rural areas. Conclusion Weight retention of married with born-child women was one of the most important factors leading to the obesity in the adulthood. However, more attentions should be paid to the changing trend of body weight in the married without childbearing experience.