Cai-Xia Zhang1, Jian-Qiang Lai2, Kai-Yan Liu1, Nian-Hong Yang3, Guo Zeng4, Li-Mei Mao5, Zeng-Ning Li6, Yue Teng7, Wei Xia8, Nan Dai9, Zhi-Xu Wang10, Yi-Xiang Su11. 1. Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China. 2. National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China. 3. Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China. 4. Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China. 5. Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China. 6. Department of Clinical Nutrition, Hebei Medical University First Affiliated Hospital, Shijiazhuang, People's Republic of China. 7. Outpatient of Nutrition Consult, Beijing Haidian District Maternal and Child Health Hospital, Beijing, People's Republic of China. 8. Department of Children's and Adolescent Health, Public Health College of Harbin Medical University, Harbin, People's Republic of China. 9. Department of Obstetrics and Gynecology, Danyang People's Hospital of Jiangsu Province, Danyang, People's Republic of China. 10. Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing211166, People's Republic of China. 11. Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou510080, People's Republic of China.
Abstract
OBJECTIVE: To establish optimal gestational weight gain (GWG) in Chinese pregnant women by Chinese-specific BMI categories and compare the new recommendations with the Institute of Medicine (IOM) 2009 guidelines. DESIGN: Multicentre, prospective cohort study. Unconditional logistic regression analysis was used to evaluate the OR, 95 % CI and the predicted probabilities of adverse pregnancy outcomes. The optimal GWG range was defined as the range that did not exceed a 1 % increase from the lowest predicted probability in each pre-pregnancy BMI group. SETTING: From nine cities in mainland China. PARTICIPANTS: A total of 3731 women with singleton pregnancy were recruited from April 2013 to December 2014. RESULTS: The optimal GWG (ranges) by Chinese-specific BMI was 15·0 (12·8-17·1), 14·2 (12·1-16·4) and 12·6 (10·4-14·9) kg for underweight, normal weight and overweight pregnant women, respectively. Inappropriate GWG was associated with several adverse pregnancy outcomes. Compared with women gaining weight within our proposed recommendations, women with excessive GWG had higher risk for macrosomia, large for gestational age and caesarean section, whereas those with inadequate GWG had higher risk for low birth weight, small for gestational age and preterm delivery. The comparison between our proposed recommendations and IOM 2009 guidelines showed that our recommendations were comparable with the IOM 2009 guidelines and could well predict the risk of several adverse pregnancy outcomes. CONCLUSIONS: Inappropriate GWG was associated with higher risk of several adverse pregnancy outcomes. Optimal GWG recommendations proposed in the present study could be applied to Chinese pregnant women.
OBJECTIVE: To establish optimal gestational weight gain (GWG) in Chinese pregnant women by Chinese-specific BMI categories and compare the new recommendations with the Institute of Medicine (IOM) 2009 guidelines. DESIGN: Multicentre, prospective cohort study. Unconditional logistic regression analysis was used to evaluate the OR, 95 % CI and the predicted probabilities of adverse pregnancy outcomes. The optimal GWG range was defined as the range that did not exceed a 1 % increase from the lowest predicted probability in each pre-pregnancy BMI group. SETTING: From nine cities in mainland China. PARTICIPANTS: A total of 3731 women with singleton pregnancy were recruited from April 2013 to December 2014. RESULTS: The optimal GWG (ranges) by Chinese-specific BMI was 15·0 (12·8-17·1), 14·2 (12·1-16·4) and 12·6 (10·4-14·9) kg for underweight, normal weight and overweight pregnant women, respectively. Inappropriate GWG was associated with several adverse pregnancy outcomes. Compared with women gaining weight within our proposed recommendations, women with excessive GWG had higher risk for macrosomia, large for gestational age and caesarean section, whereas those with inadequate GWG had higher risk for low birth weight, small for gestational age and preterm delivery. The comparison between our proposed recommendations and IOM 2009 guidelines showed that our recommendations were comparable with the IOM 2009 guidelines and could well predict the risk of several adverse pregnancy outcomes. CONCLUSIONS: Inappropriate GWG was associated with higher risk of several adverse pregnancy outcomes. Optimal GWG recommendations proposed in the present study could be applied to Chinese pregnant women.
Entities:
Keywords:
BMI; Gestational weight gain; Pregnancy outcome; Prospective cohort study