Associations of maternal pre-pregnancy body mass index and gestational weight gain with birth outcomes in Shanghai, China

Lingli Xiao,Liping Huang,Jialin Guo,Inesh Thureraja,Jian Xu,Jing Qiao,Guodong Ding,Angela Vinturache,Xiaoming Ben,Yifang Ding,Xuelei Yin

doi:10.1038/srep41073

Abstract

Recent data suggests that abnormal maternal pre-pregnancy body mass index (BMI) or gestational weight gain (GWG) is associated with unfavorable delivery outcomes. However, limited clinical evidence is available to support this correlation in China. Participating 510 mother-infant pairs were recruited from the Shanghai First Maternity and Infant Hospital, China, between January 1st and 30th 2016. Maternal pre-pregnancy BMI was categorized according to the China’s classification and GWG according to the 2009 Institute of Medicine recommendations (IOM). Linear regression tested the associations between pre-pregnancy BMI or GWG and length of gestation, birthweight, length, and head circumference. Logistic regression assessed the associations between pre-pregnancy BMI or GWG and macrosomic, small- (SGA) and large- (LGA) for-gestational-age infants. Overweight/obese women showed increased length of gestation and birthweight, but did not have a higher risk of macrosomic and LGA infants compared with normal weight women. Women with excessive GWG showed increased length of gestation, birthweight, length, and head circumference, and were more likely to deliver macrosomic and LGA infants compared with women with adequate GWG. Although a relatively low proportion of women from Shanghai area are overweight/obese or exhibit excessive GWG, both high pre-pregnancy BMI and excessive GWG influence perinatal outcomes.

Highlights

A smaller gestational weight gain (GWG) than those reported in developed countries from Europe and North America[16]
According to the 2009 Institute of Medicine (IOM) recommendations, more than half of childbearing-aged women living in north China exhibited excessive GWG19,20
Because of the strong positive associations between pre-pregnancy body mass index (BMI) and GWG and birthweight found in the linear regression analyses, we further examined the potential relationships of pre-pregnancy BMI and GWG with macrosomia, SGA or LGA infants in logistic regression analysis

Summary

Introduction

A smaller GWG than those reported in developed countries from Europe and North America[16]. To date the information on the impact of maternal pre-pregnancy BMI and GWG is scarce, especially in developing Asian countries like China. The increases in the prevalence of overweight and obesity may be attributable to the China’s economic development, which has brought with it a high degree of westernization of the traditional Chinese diet and lifestyle[17]. The increasing prevalence of unhealthy preconception BMI and inappropriate GWG among women is of great concern for the Chinese public health community. There have been only a few reports evaluating the influence of maternal pre-pregnancy BMI and GWG on delivery outcomes in Chinese women[4,19,20,21]. We aimed to investigate the current weight status of childbearing-aged women in Shanghai and to examine the possible relationships of non-optimal GWG and pre-pregnancy BMI with birth outcomes

Objectives

Methods

Results

Conclusion