Abstract
ObjectiveTo investigate recommendations for appropriate gestational weight gain (GWG) of Chinese females.MethodsIn total of 3,172 eligible women in the first trimester were recruited into the Chinese Pregnant Women Cohort Study (CPWCS) project. Pregnancy complications and outcomes were collated using the hospital medical records system. The method of occurrence of participants with adverse pregnancy outcomes (Occurrence Method) was conducted to calculate the recommended total GWG for each participant’s pre-pregnancy BMI. Occurrence Method data were judged against the Institute of Medicine (IOM) and Japanese recommended criteria in terms of the total occurrence of adverse pregnancy outcomes of pregnant women with appropriate weight gain.ResultsThe most frequent GWG was ≥ 14 kg and < 16 kg (19.4%), followed by ≥ 10 kg and < 12 kg (15.5%) and ≥ 12 kg and < 14 kg (15.2%). The most frequently occurring adverse pregnancy outcomes were cesarean sections for underweight (30.0%), normal weight (40.4%), overweight (53.6%) and obese (53.7%) women. A large for gestational age (LGA) accounted for 18.0% of the overweight and 20.9% of the obesity group. Gestational diabetes mellitus (GDM) occurred in 16.9% of overweight and 23.1% of obese women. The recommended total GWG in a Chinese women population is ≥ 8 and < 12 kg if underweight, ≥ 12 and < 14 kg for normal weight, ≥ 8.0 and < 10.0 kg if overweight, and < 8 kg for women with obesity.ConclusionsCurrent Chinese recommendations provide the optimal ranges of GWG to minimize the occurrence of undesirable pregnancy outcomes for each group of pre-pregnancy BMIs in a Chinese population.Trial registrationRegistered with ClinicalTrials (NCT03403543).
Highlights
Prenatal and postnatal care are important healthcare issues in most countries and how to improve mothers, fetus and child healthcare has become an important health goal worldwide [1]
Women who did not gain adequate weight had higher probabilities of experiencing anemia [5], preterm birth (PB) [3], and delivering low birth weight (LBW) [6] and small for gestational age (SGA) infants [7], while participants who gained excessive weight had a greater risk of having gestational diabetes mellitus (GDM) [8], gestational hypertension (GH) [9], pre-eclampsia [5] and the need for caesarean sections [6]
Pre‐pregnancy BMIs and gestational weight gain (GWG) Analysis of BMIs in pre-pregnant women and 15 GWG layer analysis of subjects revealed that pregnant women with a normal pre-pregnancy BMI accounted for the majority (65.01%), followed by overweight and obesity (21.75%) and low weight (13.24%) (Fig. 3A)
Summary
Setting and participants This study was based on CPWCS-PUMC population research from 24 hospitals in 15 provinces of China from 2017 to 2018 Pregnant women in their first trimester were selected as subjects with the following inclusion criteria: (1) Chinese nationality (2) ≥ 16 years old; (3) 5 ~ 12 weeks’ gestational age; (4) permanent residents in the study locations; (5) willing to sign written informed consent. Neonates weights < the 10th percentile and/or length ≥ 2 standard deviations below the mean for their gestational age were classified as SGA, while birth weights > the 90th percentile and/or length ≥ 2 standard deviations > the mean for their gestational age as LGAs. Neonatal adverse outcomes including LBW, MAC, SGA and LGA were collected during physicians’ home visits to the mother’s home at the sixth week postpartum. Data were collated and analyzed using Microsoft Office Excel 2013 and SPSS ver. 25
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