Optimal Gestational Weight Gain for Tibetans Based on Prepregnancy Body Mass Index

Dajie Chen,Wenzhen Li,Zuxun Lu,Xianxian Zhou,Chuanzhu Lv,Shijiao Yan,Xueyi Yang

doi:10.1038/s41598-020-65725-3

Abstract

We aimed to estimate the optimal gestational weight gain (GWG) in Tibetan women and to evaluate the appropriateness of the Institute of Medicine (IOM) GWG recommendations for Tibetan women. We analyzed data from 1474 Tibetan women from a cross-sectional study conducted in 2019. According to the three different body mass index (BMI) classification criteria (WHO BMI categories, WHO Asian BMI categories, Chinese BMI categories), we estimated the association of GWG with pregnancy outcomes (neonate birthweight and mode of delivery) using a polynomial regression model, and the optimal GWG in each BMI group was calculated. The risk of adverse outcomes showed a U-shaped curve with increasing GWG. The optimal GWG of Tibetan women based on the WHO BMI categories was 17.2 kg (range, 13.3 to 20.9 kg) for underweight, 9.3 kg (5.8 to 12.9 kg) for normal weight, and 5.2 kg (1.3 to 9.1 kg) for overweight. Underweight Tibetan mothers may gain more gestational weight than recommend by the IOM guidelines. However, normal weight Tibetan mothers are likely to benefit from gaining less weight than that recommended by the IOM. The GWG recommendations based on the IOM guidelines might not be appropriate for Tibetan women, and ethnicity-specific recommendations for GWG should be properly addressed.

Highlights

Prepregnancy body mass index (BMI) and gestational weight gain (GWG) have been known as robust predictors of pregnancy outcomes of the mother and offspring
In 2009, the Institute of Medicine (IOM) published the latest revised GWG guidelines based on the World Health Organization (WHO) BMI categories and recommended an optimal GWG of 12.5~18.0 kg for underweight pregnant women, 11.5~16.0 kg for normal weight pregnant women, 7.0~11.5 kg for overweight pregnant women and 5~9.1 kg for obese pregnant women
We analyzed the relationship between GWG and pregnancy outcomes based on three different BMI classification criteria, including the WHO BMI classification criteria, the WHO Asian BMI classification criteria and the Chinese BMI classification criteria, to propose the appropriate GWG for Tibetans with different BMI conditions and evaluate the appropriateness of the 2009 IOM GWG recommendations for Tibetan women

Summary

Introduction

Prepregnancy body mass index (BMI) and gestational weight gain (GWG) have been known as robust predictors of pregnancy outcomes of the mother and offspring. The current 2009 IOM GWG guidelines are more rigorous and complete than the previous guidelines, the recommendations were primarily based on Caucasian women; they were more appropriate in the United States and Europe Their generalizability has always been controversial worldwide. A small number of studies have explored the appropriate range of GWG in Chinese women according to prepregnancy WHO BMI categories, GWG, and various pregnancy outcomes[7,13,14,15]. These studies are concentrated in the Han population, and there is no research on the appropriate GWG for the Tibetan population. We analyzed the relationship between GWG and pregnancy outcomes based on three different BMI classification criteria, including the WHO BMI classification criteria, the WHO Asian BMI classification criteria and the Chinese BMI classification criteria, to propose the appropriate GWG for Tibetans with different BMI conditions and evaluate the appropriateness of the 2009 IOM GWG recommendations for Tibetan women

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