在怀孕期间戒烟的女性有体重过度增加的高风险吗？
2016/11/09
摘要
背景：戒烟已被报道与妊娠期较高的总体重增加（GWG）有关，这本身就是不良母婴结局的危险因素。最近的研究指出了传统的单一测量GWG的劣势，因为它们可能会导致结果的偏差。因此，我们旨在比较吸烟状况不同的妇女之间基于连续产前体重测量的GWG模式，这些妇女的吸烟状况分别为：在从不吸烟、怀孕期间戒烟、以及怀孕期间继续吸烟。
方法：我们纵向研究的参与者（N = 509）来自安大略西南部的七个产前诊所。系列GWG测量从病历中提取，吸烟状态信息从在妊娠中位数年龄为32周的自填式问卷调查得到的（27-37周）。GWG模式进行拟合分段混合效应模型评估。第一孕期体重增加和最后两个孕期的每周增加率通过吸烟状况进行比较。
结果：在第一个孕期，从不吸烟的女性和孕期戒烟的女性体重分别平均增加了1.7kg（95%可信区间：1.4-2.1）和1.2kg（0.3-2.1），而那些继续吸烟的女性获得了超过两倍（3.5kg，2.4-4.6）的体重增加。在第二孕期和第三孕期，每周体重增加率在孕期戒烟的女性中最高（0.60kg/周，0.54-0.65），比从不吸烟女性和那些在怀孕期间继续吸烟的女性分别约高20%和50%。
结论：在这个基于连续GWG测量、通过吸烟状况来检查GWG的纵向研究中，我们发现，孕期戒烟的女性在最后两个孕期中体重增加较快，表明这一高危人群可能从有针对性的干预措施中受益。
（苏欣 审校）
BMC Pregnancy Childbirth. 2016 Sep 6;16:263. doi: 10.1186/s12884-016-1056-z.
Are women who quit smoking at high risk of excess weight gain throughout pregnancy?
Hulman A1,2, Lutsiv O3, Park CK4, Krebs L4, Beyene J4, McDonald SD5.
Author information
Abstract
BACKGROUND:Smoking cessation has been reported to be associated with high total gestational weight gain (GWG), which itself is a risk factor for adverse maternal-infant outcomes. Recent studies have criticized conventional single measures of GWG, since they may lead to biased results. Therefore, we aimed to compare patterns of GWG based on serial antenatal weight measurements between women who: never smoked,quit during pregnancy, continued to smoke.
METHODS:Participants (N = 509) of our longitudinal study were recruited from seven antenatal clinics in Southwestern Ontario. Serial GWG measurements were abstracted from medical charts, while information on smoking status was obtained from a self-administered questionnaire at a median gestational age of 32 (27-37) weeks. GWG patterns were assessed by fitting piecewise mixed-effects models. First trimester weight gains and weekly rates for the last two trimesters were compared by smoking status.
RESULTS:During the first trimester, women who never smoked and those who quit during pregnancy gained on average 1.7 kg (95 % CI: 1.4-2.1) and 1.2 kg (0.3-2.1), respectively, whereas women who continued smoking gained more than twice as much (3.5 kg, 2.4-4.6). Weekly rate of gain in the second and third trimesters was highest in women who quit smoking (0.60 kg/week, 0.54-0.65), approximately 20 and 50 % higher than in women who never smoked and those who smoked during pregnancy, respectively.
CONCLUSIONS:In this longitudinal study to examine GWG by smoking status based on serial GWG measurements, we found that women whoquit smoking experienced a rapid rate of gain during the last two trimesters, suggesting that this high-risk group may benefit from targeted interventions.
KEYWORDS:Gestational weight gain; Longitudinal analysis; Piecewise mixed-effects model; Pregnancy; Smoking
BMC Pregnancy Childbirth. 2016 Sep 6;16:263. doi: 10.1186/s12884-016-1056-z.
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瑞典哮喘和COPD患者吸烟情况改变、戒烟支持和成功戒烟的相关因素
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青少年和年轻成人癌症幸存者的吸烟、合并症和总体健康状况
