postpartum weight control a vicious cycle：产后体重控制恶性循环.pdf

RESEARCH Commentary Postpartum Weight Control: A Vicious Cycle DEBRA A. KRUMMEL, PhD, RD he risk of obesity becomes most problematic for women ventions to decrease prepregnancy obesity would not only during the childbearing years, when the incidence is benefit the mother, but also potentially impact infant Thighest and the potential impact is extreme regard- mortality rates favorably, a Healthy People 2010 objective ing maternal and fetal outcomes in the short term, and (1,3,9). chronic disease risk in the long term (1-3). Disparities in During the postpartum period, three contributory fac- the prevalence of obesity occur among childbearing tors to becoming obese are excess gestational weight gain, women, with disproportionate rates seen in low-income or postpartum weight retention, and additional weight gain minority women (4). More of these women enter preg- in the postpartum period (10). The recommendations for nancy overweight, gain excess weight during each preg- ideal gestational weight gain were last published in 1990 nancy, and fail to return to their baseline prepregnant by the Institute of Medicine and were predicated on pro- body weight, creating a vicious cycle of increasing body moting weight gain that would produce the best fetal fat and obesity (5). Therefore, the postpartum period is outcomes (11). For the first time in history, the recom- especially critical for changing behaviors to promote more mended weight gain was dependent on prepregnancy healthful weight management in women. BMI. Recommended weight gain was 28 to 40 lb for For the last 40