母亲孕期增重及孕前体质量指数对学龄儿童超重肥胖的影响

Influence of gestational weight gain and preconception body mass index on overweight and obesity of school-age children

目的了解上海市浦东新区学龄儿童超重肥胖流行现状,分析孕产妇孕期增重合并孕前体质量指数(BMI)对子代学龄儿童体重状况的影响。方法2020年11—12月,采取分层整群抽样方法抽取上海市浦东新区13所小学一年级学生,与出生监测数据库比对,选取保存有完整出生信息的755例学生作为研究对象。回顾性收集母亲孕前及孕期相关信息,分析孕期增重联合孕前BMI对学龄儿童超重、肥胖的影响。结果(1)一年级学龄儿童超重肥胖检出率分别为15.89%和18.41%;(2)母亲孕期增重过度(OR=1.678)、孕前超重肥胖(OR=2.315、2.41(2)是子代学龄儿童发生超重肥胖的危险因素(P<0.05);3)孕前消瘦的母亲,若在孕期增重过度会增加子代学龄儿童超重肥胖的风险(OR=7.436,95%CI:1.489~37.143,P<0.05);(4)母亲孕期增重过度合并孕前肥胖时,其子代儿童发生超重肥胖的风险显著增加(OR=3.606,95%CI:2.030~6.405,P<0.05),而孕期增重适宜且孕前消瘦的母亲其子代学龄儿童出现超重肥胖的风险显著降低(OR=0.217,95%CI:0.049~0.967,P<0.05)。结论孕期增重过度会增加子代学龄儿童超重肥胖的发生风险,加强孕期健康教育和围生期保健工作,帮助孕妇在孕期维持适当的体重增加是预防儿童肥胖的重要策略。

Objective To understand the prevalence of overweight/obesity among school-age children in Pudong New Area of Shanghai,and to explore the influence of gestational weight gain and pre-pregnancy body mass index(BMI)on weight status of school-age children.Methods From November to December 2020,a stratified cluster sampling method was adopted to select first-grade students from 13 primary schools in Pudong New Area of Shanghai.After matching with the birth monitoring database,755 students with complete birth information were selected as the study subjects.The relevant information of mothers before and during pregnancy was retrospectively collected,and the effects of pregnancy weight gain combined with pre-pregnancy BMI on overweight/obesity in school-age children were analyzed.Results (1)The prevalence rates of overweight and obesity of first-grade children were 15.89%and 18.41%,respectively.(2)Maternal excessive weight gain during pregnancy(OR=1.678)and overweight/obesity before pregnancy(OR=2.315,2.412)were risk factors for overweight/obesity of the offspring at school age(P<0.05).(3)For mothers who were underweight before pregnancy,excessive weight gain during pregnancy was associated with overweight/obesity in school-age children in their offspring(OR=7.436,95%CI:1.489-37.143,P<0.05).(4)Excessive weight gain during pregnancy combined with overweight/obesity before pregnancy significantly increased the risk of overweight/obesity in offspring(OR=3.606,95%CI:2.030-6.405,P<0.05).Mothers who gained a moderate amount of weight during pregnancy and were emaciated before pregnancy had a significantly lower risk of overweight/obesity in their school-age children(OR=0.217,95%CI:0.049-0.967,P<0.05).Conclusion Excessive weight gain during pregnancy increases the risk of overweight/obesity in school-age children in their offspring,strengthening pregnancy health education and perinatal care to help pregnant women maintain appropriate weight gain during pregnancy may be an important and novel strategy to prevent childhood obesity.