Abstract
BackgroundTo evaluate the association between rate of gestational weight gain and preterm birth varying prepregnancy body mass indices and trimester.MethodsData from Maternal and Newborn’s Health Monitoring System on 17475 pregnant women who delivered live singletons at ≥ 28 weeks of gestation between October 2013 and September 2014 from 12 districts/counties of 6 provinces in China and started prenatal care at ≤ 12 weeks of gestation was analyzed. Gestational weight gain was categorized by rate of weight gain during the 2nd and 3rd trimester, based on the 2009 Institute of Medicine guidelines. Multivariable binary logistic regression models were conducted to investigate the association between rate of gestational weight gain and preterm birth stratified by prepregnancy body mass indices and trimester.ResultsExcessive weight gain occurred in 57.9 % pregnant women, and insufficient weight gain 12.5 %. Average rate of gestational weight gain in 2nd and 3rd trimester was independently associated with preterm birth (U-shaped), and the association varied by prepregnancy body mass indices and trimesters. In underweight women, excessive gestational weight gain was positively associated with preterm birth (OR 1.93, 95 % confidence interval (CI): 1.29- 2.88) when compared with women who gained adequately. While in overweight/obese women, insufficient gestational weight gain was positively associated with preterm birth (OR 3.92, 95 % CI: 1.13–13.67). When stratifying by trimester, we found that excessive weight gain in 3rd trimester had a significantly positive effect on preterm birth (OR 1.27, 95 % CI: 1.02–1.58).ConclusionsExcessive gestational weight gain among underweight pregnant women, insufficient gestational weight gain among overweight/obese women and excessive gestational weight gain in 3rd trimester were important predictors of preterm birth.
Highlights
To evaluate the association between rate of gestational weight gain and preterm birth varying prepregnancy body mass indices and trimester
The measure of rate of weight gain in the 2nd and 3rd trimester, in which weight gain is relatively linear and constant, would be preferable when examining the relationship between maternal weight gain and preterm birth (PTB)
The results demonstrated that both low and high rate of Gestational weight gain (GWG) in 2nd and 3rd trimester were positively associated with PTB
Summary
To evaluate the association between rate of gestational weight gain and preterm birth varying prepregnancy body mass indices and trimester. An area of growing interest is the potential association between the maternal nutritional status before and during pregnancy and the occurrence of PTB. Gestational weight gain (GWG), a strong indicator of pregnant woman’s nutritional status, is important for health and quality of life in women and their fetus. Many studies have been developed to investigate the relationship between maternal GWG and PTB. The measure of rate of weight gain (kg/week) in the 2nd and 3rd trimester, in which weight gain is relatively linear and constant, would be preferable when examining the relationship between maternal weight gain and PTB.
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