产后体重滞留影响因素的队列研究

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摘要目的探究女性产后体重滞留的影响因素。方法采用前瞻性队列研究,以在北京北方医院进行常规体检的产后1个月的女性为研究对象,进行5个月的追踪随访,调查研究对象的一般信息、孕前、分娩前、产后1个月、6个月的体重;在产后6个月,用半定量的食物频数法,收集研究对象的膳食摄入信息。利用单因素方差分析、χ²检验、多元线性回归分析等统计学方法,探究影响产后体重滞留的因素。结果孕前BMI > 24.0 kg/m²即孕前超重或肥胖者,产后1个月体重滞留约(6.4±5.5)kg,产后6个月,体重较孕前增加了(4.9±5.8) kg,均显著高于孕前BMI正常的女性;孕期增重过多,产后体重滞留程度大于孕期增重适宜以及孕期增重不足的女性(P<0.05);当脂肪供能比超过推荐值时,产后1个月、6个月BMI明显增加(P<0.05);多元线性回归分析后发现,孕期增重、产后6个月的喂养方式与产后体重滞留有关,孕期增重越多,产后6个月体重滞留越严重(β=0.73,P<0.001);与母乳喂养相比,产后6个月混合喂养的女性,更容易发生产后体重滞留(β=0.16,P=0.027)。结论孕期增重、每天能量摄入、产后6个月的喂养方式会影响产后体重的恢复,孕期增重过多,每天能量摄入过高是产后6个月体重滞留的危险因素;而产后6个月母乳喂养(包括纯母乳喂养和以母乳喂养为主)是产后6个月体重滞留的保护因素,其中孕期增重是产后体重滞留最重要的预测因子。

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	周雅琳
	朱小语
	张敏佳
	刘伟
	李雍
	秦勇
	黄汉明
	许雅君

关键词 ：孕期增重, 膳食, 喂养方式, 产后体重滞留

Abstract：Objective To explore the factors associated with postpartum weight retention. Methods A prospective cohort study was conducted among 1 month postpartum women undergoing routine physical examination in Beijing North Hospital, with 5 months following up study. Information on demographic characteristics, pre-pregnancy weight, weight before delivery, weight at 1 month postpartum, and weight at 6 months postpartum were collected through self-administered questionnaire.. The semi-quantitative Food Frequency Questionnaire (FFQ) was used for daily dietary intake 6 months after delivery. ANOVA, chi-square test and multivariate linear regression analysis were used to explore the factors correlated to postpartum weight retention. Results Women in the group of pre-pregnancy BMI>24.0kg/m² had higher weight retention than women with normal pre-pregnancy BMI. The weight retention was (6.4±5.5)kg and(4.9±5.8)kg at 1 month and 6 months postpartum respectively. Women with excessive gestational weight gain had higher postpartum weight retention than women with appropriate and inadequate weight gain (P<0.05). Women with fat energy ratio exceeded the recommended value had significant higher increase of BMI at 1 month and 6 months postpartum (P<0.05). Multivariate liner regression analysis showed that gestational weight gain and feeding modes at 6 months postpartum were significantly associated with postpartum weight retention. The severity of postpartum weight retention was related with gestational weight gain at 6 months postpartum (β=0.73,P<0.001). Compared with women breast-feeding, postpartum weight retention was more likely to occur in women who were mixed-feeding at 6 months. Conclusion Pre-pregnancy BMI, GWG, daily energy intake, and the mode of feeding at 6 months postpartum are associated with postpartum weight retention. Excessive GWG and high daily energy intake can increase the risk of postpartum weight retention at 6 months postpartum, while breastfeeding at 6 months postpartum may be a protective factor. GWG is the strongest predictor of postpartum weight retention.

Key words： gestational weight gain dietary intake feeding mode postpartum weight retention

收稿日期: 2018-03-30

通讯作者: 许雅君(xuyajun@bjmu.edu.cn)

引用本文:

周雅琳，朱小语，张敏佳，刘伟，李雍，秦勇，黄汉明，许雅君. 产后体重滞留影响因素的队列研究[J]. 中国生育健康杂志, 2019, 30(4): 316-322.
ZHOU Yalin, ZHU Xiaoyu, ZHANG Minjia, LIU Wei, LI Yong, QIN Yong, HUANG Hanming, XU Yajun. Factors associated with postpartum weight retention: A cohort study. Chinese Journal of Reproductive Health, 2019, 30(4): 316-322.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2019/V30/I4/316

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