Obstetrics & gynecology science

Korean Society of Obstetrics and Gynecology (대한산부인과학회)
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Factors related to postpartum weight retention

산후 체중 저류와 관련된 인자

Kim, Ki-Hyung;Lee, Sang-yeoup;Choi, Sang-Han;Kim, Yun-Jin;Lee, Ka-young;Lee, Kyu-Sup;Choi, Ook-Hwan;Yoon, Man-Soo
김기형;이상엽;최상한;김윤진;이가영;이규섭;최욱환;윤만수

  • Published : 20050200
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Abstract

Objective: Pre-pregnancy weight and excess weight gain during pregnancy were associated with obstetric outcomes and plasma leptin was reported to have association with postpartum weight retention. The purpose of this study was to examine the relationships between pregnancy related factors including plasma leptin and weight gain during pregnancy and postpartum weight retention. Methods: Seventy-five women were observed through pregnancy and 6 months postpartum. First trimester, third trimester and postpartum leptin were measured by radioimmunoassay. Weight gain categories were based on the Institute of Medicine recommendations. Relationships between pregnancy related factors and leptin were examined. And relationship between leptin and postpartum weight retention was also examined. Results: Among subjects, 44.0% of women had concerns for postpartum weight retention and 18.9% had diet controls for postpartum weight management. Initial BMI categories by IOM classification were underweight, 29 (38.7%), normal, 37 (49.3%), and overweight group, 9 (12.0%). Underweight group was largely below IOM weight gain recommendation and overweight group was largely over IOM weight gain recommendation (P=0.013). First trimester leptin was correlated with pregravid BMI (r=0.678, P=0.000), maternal weight at term (r=0.547, P=0.006) and postpartum BMI (r=0.608, P=0.002), but not correlated with weight gain during pregnancy and postpartum weight retention. Third trimester leptin was not correlated with above variables. Initial BMI categories by IOM were significantly correlated with first trimester leptin, leptin at 5 weeks postpartum, maternal weight at term (0.741, P=0.000), weight at 5 weeks postpartum (r=0.728, P=0.001) and weight at 6 months postpartum (r=0.684, P=0.002). Conclusion: These results suggest that first trimester plasma leptin may predict maternal weight at term and initial BMI categories may be a predictor of maternal weight at 5 weeks postpartum and 6 months postpartum. However, weight gain during pregnancy was not correlated with postpartum weight retention.

목적: 임신 전 체중과 임신 중의 지나친 체중증가는 산과적 결과에 상당한 영향을 끼치는 것으로 알려져 있다. 최근 임신중 혈장 렙틴이 산후 체중 저류의 예측인자로 제시된 바 있어 이에 저자 등은 임신 중 체중증가, 산후 체중저류와 렙틴을 포함한 임신 관련 인자들과의 관련성을 알아보고자 하였다. 연구 방법: 부산대학병원 산부인과 외래를 방문한 75명의 임부를 대상으로 임신 제 1삼분기, 제 3삼분기 및 산후 렙틴을 측정하였다. 모든 임부는 IOM 기준에 따라 저체중군, 정상군 및 과체중군으로 분류하고, 여러 산과적 인자와 렙틴 수치 등을 비교하였다. 이어 렙틴과 산후 체중저류와의 관련성을 평가하였다. 혈장 렙틴은 이중 항체 방사선면 역효소법에 의해 측정하였다. 결과: 산후 체중저류에 관심을 가진 임부는 전체의 44.0%에 불과하였고 18.9%만이 산후 체중관리를 위해 식이요법을 시행하고 있었다. IOM 기준에 따라 임신 전 저체중군은 29명 (38.7%), 정상군은 37명 (49.3%), 과체중군은 9명(12.0%)이었다. 임신 전 BMI가 높은 군에 속할수록 IOM 권고체중에 속하는 비율이 높았고 (P=0.004), 저체중군은 IOM 권고체중에 미달하는 비율이, 과체중군은 IOM 권고체중을 초과하는 비율이 유의하게 높았다 (P=0.013). 임신 제 1삼분기 혈장 렙틴은 임신 전 BMI (r=0.678, P=0.000), 만삭체중 (r=0.547, P=0.006) 및 출산직후 BMI (r=0.608, P=0.002)와 유의한 양의 관련성을 보였다. 하지만, 임신 중 체중증가량과 산후 체중 저류와는 관련성이 없었다. 임신 제 3삼분기의 렙틴 농도와 관련있는 변수는 없었다. IOM에 의한 임신 전 분류 (저체중군, 정상군 및 과체중군)는 임신 제 1삼분기말 혈장 렙틴, 출산 후 5주째 혈장 렙틴, 만삭체중 (r=0.741, P=0.000)과 출산 후 5주째 체중 (r=0.728, P=0.001) 및 출산 6개월째 체중 (r=0.684, P=0.002)과 유의한 양의 상관성을 보였다. 결론: 임신 제 1삼분기의 렙틴 수치는 만삭체중을 예측할 수 있었다. 임신 전 BMI에 근거해 미국의학연구소에 의한 임신 전 분류 (저체중군, 정상군 및 과체중군)는 만삭체중 뿐 아니라 산후 5주째 체중 및 산후 6개월째 체중을 예측하는 데 유용할 것으로 시사된다. 그러나 임신 중 체중증가량은 산후 체중저류를 예측하지 못하였다.

Keywords

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