期刊
AMERICAN JOURNAL OF CLINICAL NUTRITION
卷 102, 期 6, 页码 1460-1467出版社
ELSEVIER SCIENCE INC
DOI: 10.3945/ajcn.115.116939
关键词
body composition; gestational weight gain; maternal health; pregnancy; body fat; maternal; prepregnancy; African American; Dominican
资金
- National Institute of Environmental Health Sciences (NIEHS)
- US Environmental Protection Agency (EPA) Children's Environmental Health and Disease Prevention Research Centers [NIEHS/EPA P01ES09600/R82702701, NIEHS/EPA P01ES09600/RD832141, NIEHS/EPA P01ES09600/RD834509]
- Irving General Clinical Research Center [RR00645]
- Educational Foundation of America
- John and Wendy Neu Family Foundation
- New York Community Trust
- Trustees of the Blanchette Hooker Rockefeller Fund
- National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK T32DK091227, T32DK007559]
- PepsiCo Global R+D
Background: Excessive gestational weight gain (GWG) is associated with postpartum weight retention (PPWR) and abdominal adiposity, but long-term effects are understudied in low-income and minority populations at high risk of obesity and associated sequelae. Objective: We examined associations between GWG and long-term PPWR and adiposity in a prospective cohort of African American and Dominican mothers in the Bronx and Northern Manhattan. Design: Women (n = 302) were enrolled during pregnancy and were followed for 7 y postpartum. Linear regression was used to relate excessive GWG [ greater than 2009 Institute of Medicine (IOM) guidelines] to outcomes [percentage body fat and long-term PPWR (change in weight from prepregnancy to 7 y postpartum)], adjusting for covariates and included an interaction term between prepregnancy body mass index (BMI; in kg/m(2)) and GWG. Results: Mean +/- SD prepregnancy BMI and total GWG were 25.6 +/- 5.8 (42% of women had BMI >= 25) and 16.6 +/- 7.8 kg (64% of women had total GWG greater than IOM guidelines), respectively. Associations between GWG and long-term PPWR and the percentage body fat varied by prepregnancy BMI (P-interaction < 0.06); excessive GWG was associated with a higher percentage body fat and greater long-term PPWR in mothers with lower prepregnancy BMI. To illustrate the interaction, a predicted covariate-adjusted model, which was used to derive estimates for the percentage body fat and PPWR associated with excessive GWG, was estimated for 2 prepregnancy BMI examples. For a woman with prepregnancy BMI of 22, excessive GWG was associated with 3.0% higher body fat (P < 0.001) and a 5.6-kg higher PPWR (P < 0.001); however, for a woman with a prepregnancy BMI of 30, excessive GWG was associated with 0.58% higher body fat (P = 0.55) and 2.06 kg PPWR (P = 0.24). Conclusions: Long-term adiposity and PPWR in low-income African American and Dominican mothers were predicted by interacting effects of prepregnancy BMI and excessive GWG. The provision of support for mothers to begin pregnancy at a healthy weight and to gain weight appropriately during pregnancy may have important lasting implications for weight-related health in this population.
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