孕前体重指数、孕期增重对泌乳时间影响的纵向研究

李润; 刘丹; 王玥; 代正燕; 周容; 刘婧; 张琚; 曾果

Abstract

李润,刘丹,王玥,代正燕,周容,刘婧,张琚,曾果.孕前体重指数、孕期增重对泌乳时间影响的纵向研究[J].Chinese journal of Epidemiology,2015,36(8):803-806

孕前体重指数、孕期增重对泌乳时间影响的纵向研究

The effect of pre-pregnancy body mass index, gestational weight gain on the onset of lactation:a longitudinal study

Received:January 04, 2015

DOI：10.3760/cma.j.issn.0254-6450.2015.08.007

KeyWord: 体重指数泌乳时间孕期增重

English Key Word: Body mass index Onset time of lactation Gestational weight gain

FundProject:

Author Name	Affiliation	E-mail
Li Run	Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China
Liu Dan	Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China
Wang Yue	Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China
Dai Zhengyan	Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China
Zhou Rong	West China Second Hospital, Shichuan University
Liu Jing	Chengdu Women's and Children's Central Hospital
Zhang Ju	Sichuan Provincial Maternal and Child Health Hospital
Zeng Guo	Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China	zgmu2007@126.com

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Abstract:

目的探讨孕前BMI和孕期增重对泌乳时间的影响。方法采用纵向研究方法, 于2013年3-9月选取成都市妇幼医疗机构产前门诊751名单胎健康孕妇作为基线调查对象, 在其分娩前后各随访一次, 最终以473名孕妇作为研究对象, 通过问卷调查和病历记录获得其孕前体重、分娩方式、新生儿出生体重、泌乳时间及基本信息, 测量身高和分娩前体重, 计算孕期增重;控制分娩方式、母亲年龄等混杂因素后, 采用多因素有序logistic回归模型分析孕前BMI和孕期增重与泌乳时间的关系。结果调查对象泌乳时间<1、1~、24~、48~和≥72 h的构成比分别占16.3%、37.0%、17.5%、18.6%和10.6%。与孕前体重正常组相比, 孕前消瘦和孕前超重或肥胖均是泌乳时间延长的危险因素, OR值(95%CI)分别为2.85(1.91~4.27)和 3.42(1.69~6.90)。与孕前体重正常且孕期增重适宜组相比, 孕前消瘦且孕期增重适宜和过多均是泌乳时间延长的危险因素, OR值(95%CI)分别为2.34(1.31~4.18)和3.42(1.67~7.00);孕前超重或肥胖且孕期增重过多是泌乳时间延长的危险因素, OR值(95%CI)为3.10(1.15~8.37)。结论孕前BMI是泌乳时间的独立影响因素, 孕期增重需联合孕前BMI对泌乳时间产生影响。

English Abstract:

Objective To explore the effect of pre-pregnancy body mass index(BMI) and gestational weight gain(GWG) on the onset time of lactation (OL). Methods In this longitudinal study, 751 healthy single pregnant women were selected from three hospitals in Chengdu as subjects of baseline survey during March and September 2013 and were followed before and after delivery, respectively. Finally, data from a total of 473 pregnant women were analyzed. Data on pre-pregnancy weight, delivery mode, birth weight of neonate, information of lactation and maternal demographic characteristics were collected through questionnaire and medical records. Height and weight at the last week before delivery were measured and GWG were calculated. After controlling the potential confounders, a serial of multi-factor ordinal logistic regression models were performed to test the associations between pre-pregnancy BMI, GWG and OL. Results The proportions of OL at the <1, 1-, 24-, 48-and ≥72 h groups were 16.3%, 37.0%, 17.5%, 18.6% and 10.6%, respectively. When compared to women with normal weight, the ORs for prolonged OL were 2.85(1.91-4.27) and 3.42 (1.69-6.90) among pre-pregnant underweight and overweight/obese women, respectively. When compared to women with normal weight and adequate GWG, pre-pregnant underweight women with adequate and excessive GWG showed greater odds of prolonged OL(OR=2.34, 95%CI: 1.31-4.18;OR=3.42, 95%CI: 1.67-7.00), respectively. Pre-pregnant overweight/obese women with excessive GWG had increased the odds of prolonged OL (OR=3.10, 95%CI: 1.15-8.37). Conclusion Pre-pregnant BMI appeared an independently factor, associated with OL while GWG might have an effect on OL, when pre-pregnant BMI was considered.

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