Effects of Prepregnancy Body Mass Index, Weight Gain, and Gestational Diabetes Mellitus on Pregnancy Outcomes: A Population-Based Study in Xiamen, China, 2011–2018

Su, Weijuan; Chen, Yin-ling; Huang, Peiying; Shi, Xiulin; Yan, Fangfang; Chen, Zheng; Yan, Bing; Song, Haiqu; Lin, Mingzhu; Li, Xuejun

doi:10.1159/000501710

Cited by 38 publications

(33 citation statements)

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“…However, we did not nd a signi cant relationship between obesity and macrosomia, consistent with a previous retrospective study found that high BMI had no signi cant impact on the risk of delivering LGA newborn or macrosomia, in PCOS women who underwent frozen embryo transfer (17). A study on general pregnant Chinese women found that overweight and obese women were more prone to have LGA and macrosomia compared to normal weight counterparts (18). A possible explanation for this phenomenon may be that different ways of conception have certain effects on pregnancy outcomes.…”

Section: Discussionsupporting

confidence: 89%

Associations between pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in women with polycystic ovary syndrome

Zhang

Zheng

Liu

et al. 2020

Preprint

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BackgroundPolycystic ovary syndrome (PCOS), a reproductive endocrine disorder affecting females of childbearing age, is associated with poor pregnancy outcomes. Both inappropriate pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) could affect the perinatal outcomes in general pregnant women, which raises the question whether various BMI or GWG has impact on pregnancy outcomes in PCOS women. Therefore, we conducted a retrospective study in 722 PCOS women to explore the associations between pre-pregnancy BMI and GWG with pregnancy outcomes among PCOS women with the view of generating vital information that can guide weight management in this group of individuals.MethodsA retrospective study was conducted targeting baseline characteristics, laboratory data and pregnancy outcomes in 722 singleton pregnant women. We performed multivariable logistic regression analysis to investigate the relationship between BMI and GWG with perinatal outcomes after controlling for appropriate confounding factors.ResultsOur results showed that being underweight were increased the risk of small for gestational age (SGA), but reduced the risk of large for gestational age (LGA). In addition, we found overweight but not obesity individuals were more susceptible to develop preeclampsia compared those with normal weights. For PCOS women with BMI＜25 kg/m2 before pregnancy, inadequate GWG was a protective factor for gestational hypertension and postpartum hemorrhage(PPH). However, excessive GWG increased the possibility of LGA birth in individuals with BMI＜25 kg/m2 . Excessive GWG also increased the chances of undergoing a cesarean section in individuals with BMI ≥ 25 kg/m2. Inadequate GWG didn’t reduce the risk of LGA for women with BMI ≥ 25 kg/m2, similarly, excessive GWG didn’t decrease the chance of delivering SGA infant for women with BMI＜25 kg/m2.ConclusionThe impacts of pre-pregnancy BMI, GWG on maternal and infant outcomes among PCOS women are similar to what has been reported in general pregnant women. However, some unique trends exist in PCOS women. Overall, these findings indicate that women with PCOS need to begin weight management before pregnancy.

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Section: Discussionsupporting

confidence: 89%

Associations between pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in women with polycystic ovary syndrome

Zhang

Zheng

Liu

et al. 2020

Preprint

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“…However, there was no signi cant relationship between obesity and macrosomia, consistent with a previous retrospective study, which indicated that high BMI had no signi cant impact on the risk of delivering LGA newborn or macrosomia, in PCOS women who underwent frozen embryo transfer (19). A study involving general pregnant Chinese women found that overweight and obese women were more prone to have LGA and macrosomia compared with normal weight counterparts (20). A retrospective study involving 7122 general pregnant women from Bratislava, Slovakia, revealed that women with overweight and obesity had a 1.7-1.8 fold risk of macrosomia compared with normal weight women (21), but the study did not examine the correlation between BMI and LGA birth.…”

Section: Discussionsupporting

confidence: 87%

Associations between pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in women with polycystic ovary syndrome

Zhang

Zheng

Liu

et al. 2020

Preprint

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Background: The influence of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on perinatal outcomes of women with polycystic ovary syndrome (PCOS) remains unclear. Therefore, we explored how the above indicators influence pregnancy outcomes in women with PCOS. Methods: A retrospective study was conducted involving the baseline characteristics, laboratory data, and pregnancy outcomes of 722 pregnant women with PCOS. Subjects were grouped in a way to find out risks in their pregnancy outcomes. Multivariable logistic regression analysis was performed to investigate how BMI and GWG were associated with perinatal outcomes.Results：Among women with PCOS, underweight increased the risk of small for gestational age (SGA) (OR 12.35, 95% CI 3.56-42.82), but reduced the risk of large for gestational age (LGA). Overweight but not obese women were more susceptible to developing preeclampsia (PE) than women with normal weight. In PCOS women with BMI＜25 kg/m2 before pregnancy, inadequate GWG was a protective factor for gestational hypertension (GH) and postpartum hemorrhage (PPH), excessive GWG exhibited a positive correlation with LGA. But in PCOS women with BMI ≥25 kg/m2, excessive GWG increased the probability of undergoing a cesarean section. Inadequate GWG did not reduce the likelihood of LGA in women with BMI ≥ 25 kg/m2, and excessive GWG did not reduce the probability of SGA in women with BMI＜25 kg/m2.Conclusion: The impacts of pre-pregnancy BMI, GWG on maternal and infant outcomes among PCOS women are similar to reported results in general pregnant women. However, some unique trends were also observed in PCOS women. While the underweight factor significantly increased the risk of SGA birth, overweight but not obesity was correlated with the risk of PE. Inadequate GWG was a protective factor for GH and PPH only in women with pregestational BMI＜25 kg/m2. Inadequate GWG did not reduce the probability of LGA in women with BMI ≥ 25 kg/m2, and similarly, excessive GWG did not reduce the probability of SGA in women with BMI＜25 kg/m2. Overall, these findings indicate that women with PCOS should begin weight management before pregnancy.

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“…A total of 95.9% studies were prospective or retrospective cohorts and 4% were cross-sectional studies [20,21]. In addition, 17 (34.6%) studies used the GDM classification of group 1 [21,22,26,35,38,40,47,48,50,51,53,54,[59][60][61]64,67] and IADPSG; 7 (14.2%) group 2 [20,27,28,51,59,65,68], 3 (6.1%) group 3 [32,46,56], 1 (2%) group 4 [51], 19 (38.7%) group 5 [23][24][25]29,31,33,34,36,39,40,42,44,47,53,55,57,58,64,66], 6 (12.2%) group 6…”

Section: Discussionmentioning

confidence: 99%

The Impact of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Maternal Outcomes: A Systematic Review and Meta-Analysis

Tehrani

Naz

Behboudi‐Gandevani

2021

JCM

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This systematic review and meta-analysis aimed to examine the impact of different gestational-diabetes (GDM) diagnostic-criteria on the risk of adverse-maternal-outcomes. The search process encompassed PubMed (Medline), Scopus, and Web of Science databases to retrieve original, population-based studies with the universal GDM screening approach, published in English language and with a focus on adverse-maternal-outcomes up to January 2020. According to GDM diagnostic criteria, the studies were classified into seven groups. A total of 49 population-based studies consisting of 1409018 pregnant women with GDM and 7,667,546 non-GDM counterparts were selected for data analysis and knowledge synthesis. Accordingly, the risk of adverse-maternal-outcomes including primary-cesarean, induction of labor, maternal-hemorrhage, and pregnancy-related-hypertension, overall, regardless of GDM diagnostic-criteria and in all diagnostic-criteria subgroups were significantly higher than non-GDM counterparts. However, in meta-regression, the increased risk was not influenced by the GDM diagnostic-classification and the magnitude of the risks among patients, using the IADPSG criteria-classification as the most strict-criteria, was similar to other criteria. In conclusion, a reduction in the diagnostic-threshold increased the prevalence of GDM, but the risk of adverse-maternal-outcome was not different among those women who were diagnosed through more or less intensive strategies. Our review findings can empower health-care-providers to select the most cost-effective approach for the screening of GDM among pregnant women.

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Effects of Prepregnancy Body Mass Index, Weight Gain, and Gestational Diabetes Mellitus on Pregnancy Outcomes: A Population-Based Study in Xiamen, China, 2011–2018

Cited by 38 publications

References 0 publications

Associations between pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in women with polycystic ovary syndrome

Associations between pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in women with polycystic ovary syndrome

Associations between pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in women with polycystic ovary syndrome

The Impact of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Maternal Outcomes: A Systematic Review and Meta-Analysis

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