Comparison of the 2009 Institute of Medicine and 2021 Chinese guidelines for gestational weight gain: A retrospective population‐based cohort study

Abstract

ObjectiveTo analyze the associations between gestational weight gain (GWG) and perinatal outcomes based on the GWG guidelines of the Chinese Nutrition Society (CNS) and the Institute of Medicine (IOM).MethodsThis was a retrospective study with 9075 low‐risk singleton pregnant women. Logistic regression model was used to analyze associations between GWG categories and perinatal outcomes. Sensitivity analyses were performed based on pre‐pregnancy body mass index (calculated as weight in kilograms divided by the square of height in meters).ResultsExcessive GWG as defined by the two guidelines was associated with a higher risk of adverse perinatal outcomes. Inadequate GWG was associated with higher risks of small for gestational age (adjusted odds ratio [aOR] 1.34, 95% confidence interval [CI] 1.10–1.64) and preterm birth (aOR 1.70, 95% CI 1.22–2.36), but a lower risk of large for gestational age (LGA) (aOR 0.77, 95% CI 0.63–0.95) according to the IOM guidelines. When using the CNS guidelines, inadequate GWG was associated with only a lower risk of preterm birth (aOR 1.80, 95% CI 1.19–2.70). Sensitivity analyses suggested that excessive GWG was associated with a higher risk of LGA in underweight women.ConclusionsBoth guidelines could demonstrate the relationship between GWG and adverse perinatal outcomes. The CNS guidelines were more suitable for the Chinese population with underweight or normal weight before pregnancy, whereas IOM was more suitable for pregnant women with inadequate GWG.

Effects of a Comprehensive Dietary Intervention Program, Promoting Nutrition Literacy, Eating Behavior, Dietary Quality, and Gestational Weight Gain in Chinese Urban Women with Normal Body Mass Index during Pregnancy

“…Evidence supporting this inference comes from the CDIP group’s intervention results. The CDIP intervention demonstrated a significant positive impact, assisting women in controlling excessive weight gain, with a greater proportion of pregnant women achieving weight gain within the industry-standard range set by the Chinese National Health Commission [ 109 , 110 , 111 ]. CDIP, by emphasizing and monitoring weight gain, provided specific and practical weekly weight-gain goals and real-time-adjusted dietary guidance.…”