产妇久坐行为对产后一年体重滞留影响的研究

Influence of sedentary behavior on weight retention among postpartum women within one year ;after childbirth

目的：分析孕妇产后久坐行为对产后体重滞留的情况及其影响因素。方法2012年5月至2013年8月在合肥市妇幼保健所收集1220名产后42 d产妇建立基线资料，从该市孕产妇信息管理系统获取孕前体重及分娩信息，分别于产后3、6、9、12个月随访，观察产妇久坐时间等指标，采用重复测量资料的方差分析和混合效应模型分析产妇久坐与体重滞留的关系。结果1220名产妇最终追踪到有效数据者1141名。该研究人群孕前体重为（53.22±6.88）kg，产后42 d和3、6、9、12个月的体重（kg）滞留分别为7.85±5.11、7.51±5.40、5.79±5.18、4.42±4.91、3.26±4.65。重复测量资料方差分析结果显示，孕妇产后不同时间段体重滞留的差异有统计学意义（P＜0.001）；混合效应模型显示，分步调整孕前BMI、哺乳方式、分娩方式等混杂因素后，产妇久坐行为与产后体重滞留间的差异有统计学意义（P＜0.001），逐步调整混杂因素后显示混合效应模型结果稳定。结论产妇久坐是影响产后体重滞留重要因素之一。

Objective To identify the risk factors that affect the postpartum weight retention among women and provide evidence for the prevention of obesity and metabolic disorders due to childbirth. Methods The baseline data were collected from 1 220 postpartum women who had given childbirth 42 days ago in Hefei Maternal and Child Health Care Center,Anhui province. Their pre-pregnancy weight,weight gain during pregnancy and childbirth information were obtained from local maternal information management system,and the follow up for the women were conducted at 3,6,9,and 12 months after childbirth. The sedentary behaviors of the women were observed. The relationship between postpartum weight retention and sedentary behavior of the women were analyzed by mixed-effects model analysis and repeated measures analysis of variance. Results The pre-pregnancy average body weight（kg）of the women was（53.22 ± 6.88）,and their postpartum average body weight retention was（7.85±5.11）,（7.51±5.40）,（5.79±5.18）,（4.42±4.91）and （3.26±4.65）at 42 days,3,6,9,12 months later after childbirth,respectively. The differences in body weight retention at different times after childbirth indicated by repeated measures analysis of variance were statistical significant （P〈0.001）. Mixed-effects model analysis showed the postpartum sedentary behavior and postpartum body weight retention was statistically associated after adjusting for pre-pregnancy BMI,feeding pattern,delivery mode and other confounding factors（P〈0.001）, Mixed-effects model analysis results tended to be stable after step by step adjustment for confounding factors. Conclusion The results of this study suggested that postpartum sedentary behavior is one of the important factors influencing postpartum weight retention.