The pattern of gestational weight gains among Chinese women: a repeated measure analysis

Jing Tan,Xin Sun,Yan Ren,Guolin He,Yana Qi,Sheyu Li,Li Tang,Xinghui Liu,Peng Chen

doi:10.1038/s41598-018-34227-8

Abstract

This study aimed to investigate the pattern of gestational weight gain (GWG) among Chinese women. We included pregnant women, who delivered at a referral medical center in China and had no pre-specified adverse pregnancy outcomes. We collected weight data across all pregnancy visits, and used the two-level spline linear model to fit for the pattern of GWG according to pre-pregnancy BMI categories. In total, 4,567 pregnant women with 47,699 repeated measures were eligible. For those who were underweight, normal and overweight before pregnancy, the interquartile ranges (25th to 75th quartiles) of GWG between 14 and 36 gestational weeks were 12.9–17.7 kg, 12.6–17.3 kg and 11.7–16.8 kg, and the corresponding rates of GWG were 2.62 kg/month, 2.56 kg/month and 2.37 kg/month. For underweight and normal women, the rates of GWG were similar before 14 weeks (0.57 and 0.58 kg/month) and after 36 weeks (1.69 and 1.70 kg/month); however, the rates of GWG were higher for overweight women (0.66 kg/month before 14 weeks and 1.89 kg/month after 36 weeks). In summary, the pattern of GWG among Chinese pregnant women is generally consistent with the IOM recommendation, particularly for those who are normal or underweight. Modifications are, however, warranted for overweight pregnant women.

Highlights

Gestational weight gain (GWG) is closely associated with many adverse neonatal and maternal outcomes
In order to compare gestational weight gain (GWG) recommended by the Institute of Medicine (IOM) guideline, we reported interquartile range (25th to 75th percentile) and 90% percentile range (5th to 95th percentile) of GWG according to pre-pregnancy body mass index (BMI)
We found that, compared to the IOM recommendations[12], the Chinese pregnant women had more weight gains if pre-pregnancy BMI was normal (25–75th percentile: 12.6–17.3 kg in the Chinese versus 11.5–16 kg according to IOM); the weight gain was even more significant among those who were overweight before pregnant (25–75th percentile: 11.7–16.8 kg versus 7–11.5 kg)

Summary

Introduction

Gestational weight gain (GWG) is closely associated with many adverse neonatal and maternal outcomes. Insufficient weight gain may increase the risk of preterm birth, small-for-gestational-age babies, and fetal death[5,6,7]. The U.S Institute of Medicine (IOM) released the guideline for managing weight gain and nutrition during pregnancy in 199011 and an updated version in 200912, both of which offered recommendations about gestational weight gains for women with different body mass index (BMI) before pregnancy. Pregnant women, especially those with excessive weight gain, are usually required to control weight starting 36 gestational weeks in China (but not in the U.S population). Because of these differences, the pattern of weight gain during pregnancy may differ between the U.S and the Chinese population. Another study from Taiwan showed that, using the IOM recommendation, women with normal weight and underweight had increased risk of low birth weight[20]

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