Association of trimester-specific gestational weight gain with fetal growth, offspring obesity, and cardiometabolic traits in early childhood

作者：Karachaliou Marianna^*; Georgiou Vaggelis; Roumeliotaki Theano; Chalkiadaki Georgia; Daraki Vasiliki; Koinaki Stella; Dermitzaki Eirini; Sarri Katerina; Vassilaki Maria; Kogevinas Manolis; Oken Emily; Chatzi Leda

来源：American Journal of Obstetrics and Gynecology, 2015, 212(4): 502.e1.

DOI：10.1016/j.ajog.2014.12.038

• blood pressure
• children
• gestational weight gain
• obesity
• pregnancy cohort

OBJECTIVE: The purpose of this study was to investigate the association of trimester-specific gestational weight gain with offspring fetal growth, obesity risk, and cardiometabolic health outcomes from birth to 4 years of age.
STUDY DESIGN: We conducted the present study with 977 motherchild pairs of the pregnancy cohort "Rhea" study in Crete, Greece. We measured birthweight, body mass index from 6 months to 4 years of age, waist circumference, skinfold thickness, blood pressure, and blood levels of lipids, C-reactive protein, and adipose tissue hormones at 4 years of age. We used multiple linear and log Poisson regression models to examine the association of exposure with continuous or binary outcomes, respectively.
RESULTS: Greater rate of gestational weight gain in the first trimester of pregnancy (per 200 g/wk) was associated with increased risk of overweight/obesity from 2 years (relative risk [RR], 1.25; 95% confidence interval [CI], 1.09-1.42) to 4 years of age (RR, 1.15; 95% CI, 1.05-1.25), but not with birth size. Each 200 g/wk of weight gain in the first trimester of pregnancy was also associated with greater risk of high waist circumference (RR, 1.13; 95% CI, 1.04-1.23), high sum of skinfold thickness (RR, 1.15; 95% CI, 1.02-1.29), and higher diastolic blood pressure at 4 years of age (beta, 0.43 mm Hg; 95% CI, 0.00-0.86). Greater rate of gestational weight gain during the second and third trimesters of pregnancy (per 200 g/wk) was associated with greater risk of largefor- gestational-age neonates (RR, 1.22; 95% CI, 1.02, 1.45) and higher levels of cord blood leptin (ratio of geometric means, 1.08; 95% CI, 1.00-1.17), but not with child anthropometry at later ages.
CONCLUSION: Timing of gestational weight gain may influence childhood cardiometabolic outcomes differentially.

• 出版日期2015-4
• 单位河北医科大学