Association among pre-pregnancy body mass index, gestational weight gain and neonatal birth weight: a prospective cohort study in China

Abstract

Background This study aims to explore the relationships between pre-pregnancy body mass index (BMI), gestational weight gain (GWG), rate of GWG during the second and third trimesters (GWGrate) and birth weight among Chinese women. Methods Women were enrolled by 24 hospitals in 15 different provinces in mainland China from July 25th, 2017 to 26 November 2018. Pre-pregnancy BMI, GWG and GWGrate were calculated and divided in to different groups. The multinomial logistic regression model and restrictive cubic spline model were used to explore the relationships. Results Of the 3585 participants, women who were underweight, had insufficient GWG or GWGrate had 1.853-, 1850- or 1.524-fold higher risks for delivering small-for-gestational-age (SGA) infant compared with women who had normal BMI, sufficient GWG or GWGrate. Women who were overweight/obese, had excessive GWG or GWGrate had 1.996-, 1676- or 1.673-fold higher risks for delivering large-for-gestational-age (LGA) infant. The effects of GWG and GWGrate on birth weight varied by pre-pregnancy BMI statuses. Dose-response analysis demonstrated L-shaped and S-shaped relationships between pre-pregnancy BMI, GWG, GWGrate and neonatal birth weight. Conclusions Pre-pregnancy BMI, GWG or GWGrate were associated with neonatal birth weight among Chinese women. Both body weight before and during pregnancy should be maintained within the recommendations to prevent abnormal birth weight.

Analysis of the Influence of Pre-Pregnancy BMI and Weight Gain during Pregnancy on the Weight of Healthy Children during the First 2 Years of Life: A Prospective Study

“…The greatest limitation of this study was the small number of patients studied. Despite the fact that it did not reduce the confidence interval (moderate effect size) in which we find significance (type I errors), it may toughen the interpretation of negative results, which can be seen when compared with large cohort studies e.g., those conducted in China [ 5 , 32 ]. As a part of our research, we only used measurements of mothers’ weight at conception, at labor and total gestational weight gain without distinction of GWG in trimesters, only as an exposure factor.…”

“…Pre-pregnancy maternal overweight and obesity and gestational weight gain (GWG) have been demonstrated to increase complication rates during gestation and delivery including gestational hypertension, preeclampsia, gestational diabetes mellitus, increased rates of cesarean delivery, prematurity, still birth, congenital anomalies, macrosomia and shoulder dystocia [ 1 , 2 , 3 ]. Pre-pregnancy maternal BMI (pBMI) and GWG are associated in a direct manner with infants’ birthweight [ 4 , 5 ] and result in the programming of child weight and impact its later weight gain (“fetal programming”) [ 6 ]. The above-mentioned factors have also been shown to affect childhood development causing future obesity, diabetes, neurodevelopment and augmented cardiovascular risk [ 7 , 8 , 9 , 10 ].…”

Clinical Observation of Effects of Prepregnancy Body Mass Index and Weight Gain during Pregnancy on Neonatal Weight and Delivery Outcome

“…Measurement of postpartum hemorrhage [ 10 ]: postpartum bleeding volume >500 ml. Criteria of neonatal weight: low-weight infants <2500 g, normal-weight infants from 2500 g to 4000 g, and macrosomia infants ≥4000 g. Measurement of premature delivery: gestation less than 37 weeks.…”

“…In clinical practice, body mass index (BMI) and weight gain during pregnancy are used for measuring maternal nutritional conditions and fetal growth [ 4 ]. In recent years, the increase of BMI before pregnancy and during pregnancy increases significantly, which results in an increased incidence of hypertensive disorder in pregnancy (HDP) and abnormal glucose and lipid metabolism and affects the growth and gestational age of the fetus [ 5 – 7 ]. The purpose of the study is to analyze the relationship between BMI of pregnant women before pregnancy, weight gain during pregnancy, and neonatal weight and delivery outcome to provide scientific reference for clinical perinatal healthcare of the parturient.…”

Analysis of the Weight Management Behavior of Chinese Pregnant Women: An Integration of the Protection Motivation Theory and the Information-Motivation-Behavioral Skills Model

“…Inappropriate GWG not only has short-term health effects such as causing pregnancy complications, cesarean deliveries, macrosomia, and preterm birth, but also long-term health effects such as postpartum weight retention and childhood chronic diseases (1)(2)(3)(4). According to recommendations made by the Institute of Medicine (IOM) (5), appropriate GWG is as low as 40%, and excessive GWG has exceeded 50% in some countries (6,7). Therefore, improving weight management during pregnancy has become a pressing concern today.…”