Abstract
ObjectiveTo assess whether pre-pregnancy body mass index (BMI) modify the relationship between gestational weight gain (GWG) and child birth weight (specifically, presence or absence of low birth weight (LBW) or presence of absence of macrosomia), and estimates of the relative risk of macrosomia and LBW based on pre-pregnancy BMI were controlled in Wuhan, China.MethodsFrom June 30, 2011 to June 30, 2013. All data was collected and available from the perinatal health care system. Logistic regression models were used to estimate the independent association among pregnancy weight gain, LBW, normal birth weight, and macrosomia within different pre-pregnancy BMI groups. We built different logistic models for the 2009 Institute of Medicine (IOM) Guidelines and Chinese-recommended GWG which was made from this sample. The Chinese-recommended GWG was derived from the quartile values (25th-75th percentiles) of weight gain at the time of delivery in the subjects which comprised our sample.ResultsFor LBW children, using the recommended weight gain of the IOM and Chinese women as a reference, the OR for a pregnancy weight gain below recommendations resulted in a positive relationship for lean and normal weight women, but not for overweight and obese women. For macrosomia, considering the IOM’s recommended weight gain as a reference, the OR magnitude for pregnancy weight gain above recommendations resulted in a positive correlation for all women. The OR for a pregnancy weight gain below recommendations resulted in a negative relationship for normal BMI and lean women, but not for overweight and obese women based on the IOM recommendations, significant based on the recommended pregnancy weight gain for Chinese women. Of normal weight children, 56.6% were above the GWG based on IOM recommendations, but 26.97% of normal weight children were above the GWG based on Chinese recommendations.ConclusionsA GWG above IOM recommendations might not be helpful for Chinese women. We need unified criteria to classify adult BMI and to expand the sample size to improve representation and to elucidate the relationship between GWG and related outcomes for developing a Chinese GWG recommendation.
Highlights
Gestational weight gain (GWG) is an important indicator to monitor and evaluate a pregnant woman’s nutritional status
Pre-Pregnancy Body Mass Index, GWG, and Birth Weight and obese women based on the Institute of Medicine (IOM) recommendations, significant based on the recommended pregnancy weight gain for Chinese women
56.6% were above the GWG based on IOM recommendations, but 26.97% of normal weight children were above the GWG based on Chinese recommendations
Summary
Gestational weight gain (GWG) is an important indicator to monitor and evaluate a pregnant woman’s nutritional status. Studies have shown that GWG is related to low birth weight (LBW) and macrosomia. The prevalence of macrosomia worldwide has been increasing to 4.7–13.1% [1–4]. In China, the incidence of macrosomia was 3.4– 11.67% from 2005 to 2011 [5–8]. Macrosomia is associated with significant maternal and neonatal morbidity such as shoulder dystocia, caesarean birth, newborn asphyxia [6,9,10], and childhood obesity, as well as a high risk of cardiovascular diseases, diabetes, metabolic diseases, and obesity in adulthood [8]. Many studies reported that a high GWG was linearly correlated with macrosomia and excessive birth weight [11,12,13]. One cohort study reported that if a mother’s body mass index (BMI) increased by 25% or more during pregnancy, 86.2% of the babies had macrosomia; a high GWG was demonstrated to result in macrosomia [14]
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