年轻女性生育多胎可增加肥胖风险

芝加哥——密歇根大学的Michelle H. Moniz博士在本届美国妇产科医师学会年会上报告了一项根据2001年至2010年美国国家健康和营养调查研究（NHANES）数据分析研究的结果，研究结果显示，女性年轻时生育多胎可增加年长后肥胖风险，研究提示，年轻经产妇是需要督促减肥的关键人群。

该研究纳入4979名调查时年龄在20～50岁之间、体质量指数（BMI）在16.5～70 kg/m2之间的女性，且当时和近期均未怀孕。Moniz博士报告，在修正种族、民族、收入以及NHANES研究波动因素后发现，20～25岁的经产妇出现肥胖几率几乎是同年龄组中未孕未产女性的两倍（比值比，1.91）。在其他组间或初产与未孕未产女性之间任何年龄组中均未发现显著差异。

Moniz博士强调到，虽然研究受限于无法评估的母乳喂养影响以及横断面研究设计的相关因素（如无法确认生育是否发生在肥胖发生前），但该研究重点关注的是年轻女性解决肥胖问题的重要性。

Moniz博士还指出，“肥胖影响着美国三分之一以上的女性，且终身健康均受其威胁，”   已有研究证实，肥胖一旦出现，就很难扭转。

此外，生育增加了女性肥胖的风险，年轻母亲由于贫困、较低的教育程度以及青春期生理与生长相关的内分泌水平变化因素已经导致肥胖风险增加，生育则可能成为其一个特别重要的危险因素。

Moniz博士总结道，“预防青少年及年轻成年女性意外怀孕可能是一个有助降低肥胖患病率以及减少女性肥胖持续时间的重要策略。”

Moniz博士报告无相关经济利益冲突。

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By: SHARON WORCESTER, Internal Medicine News

AT THE ACOG ANNUAL CLINICAL MEETING

VITALS

Key clinical point: Consider addressing obesity concerns among multiparous women in their 20s.

Major finding: Adjusted odds ratio for obesity among multiparous vs. nulligravid women aged 20-25 years: 1.91.

Data source: A review of NHANES data on 4,979 women.

Disclosures: Dr. Moniz reported having no relevant financial disclosures.

CHICAGO – Women who have multiple children early in life are at increased risk for obesity early in adulthood, according to an analysis of National Health and Nutrition Examination Survey data.

The findings, from pooled 2001-2010 NHANES data, suggest that young multiparous women are a critical target group for obesity reduction efforts, Dr. Michelle H. Moniz of the University of Michigan, Ann Arbor, reported in a poster at the annual meeting of the American Congress of Obstetricians and Gynecologists.

The 4,979 women included in the study were aged 20-50 years at the time they were surveyed, and had a body mass index between 16.5 and 70 kg/m2. They were not currently or recently pregnant.

After adjustment for race, ethnicity, income, and NHANES study wave, multiparous women aged 20-25 years were almost twice as likely as nulligravid women in that age group to be obese (odds ratio, 1.91). No significant differences were seen for other age groups or for primiparous vs. nulligravid women in any of the age groups, Dr. Moniz found.

Although limited by an inability to account for the effect of breast-feeding due to significant missing data and restriction on sample size, as well as by factors associated with its cross-sectional design – such as an inability to determine whether childbearing occurred before the onset of obesity – the study nevertheless highlights the importance of addressing the issue of obesity in young women, according to Dr. Moniz.

"Obesity affects more than a third of women in the United States and is a profound, persistent threat to health throughout the life course," she wrote, noting that studies have shown that once obesity is established, it is difficult to reverse.

Furthermore, childbearing increases the risk of obesity in women, and may be a particularly important risk factor in young mothers due to their increased risk of poverty, lower educational attainment, and endocrine parameters associated with physiologic growth during adolescence.

"Preventing unplanned pregnancies in adolescent and young adult women may be an important strategy to help reduce obesity prevalence and duration of exposure to obesity in women," Dr. Moniz concluded

Dr. Moniz reported having no relevant financial disclosures.