Full Text:   <1719>

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Suppl. Mater.: 

CLC number: R715.3

On-line Access: 2017-03-08

Received: 2016-05-06

Revision Accepted: 2016-09-30

Crosschecked: 2017-02-17

Cited: 1

Clicked: 3339

Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Meng-kai Du

http://orcid.org/0000-0002-6711-1034

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Journal of Zhejiang University SCIENCE B 2017 Vol.18 No.3 P.263-271

http://doi.org/10.1631/jzus.B1600204


Effects of pre-pregnancy body mass index and gestational weight gain on neonatal birth weight


Author(s):  Meng-kai Du, Li-ya Ge, Meng-lin Zhou, Jun Ying, Fan Qu, Min-yue Dong, Dan-qing Chen

Affiliation(s):  Department of Obstetrics and Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China; more

Corresponding email(s):   Chendq@zju.edu.cn

Key Words:  Pre-pregnancy body mass index, Gestational weight gain, Neonatal birth weight, Appropriate weight gain pattern


Meng-kai Du, Li-ya Ge, Meng-lin Zhou, Jun Ying, Fan Qu, Min-yue Dong, Dan-qing Chen. Effects of pre-pregnancy body mass index and gestational weight gain on neonatal birth weight[J]. Journal of Zhejiang University Science B, 2017, 18(3): 263-271.

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author="Meng-kai Du, Li-ya Ge, Meng-lin Zhou, Jun Ying, Fan Qu, Min-yue Dong, Dan-qing Chen",
journal="Journal of Zhejiang University Science B",
volume="18",
number="3",
pages="263-271",
year="2017",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1600204"
}

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%T Effects of pre-pregnancy body mass index and gestational weight gain on neonatal birth weight
%A Meng-kai Du
%A Li-ya Ge
%A Meng-lin Zhou
%A Jun Ying
%A Fan Qu
%A Min-yue Dong
%A Dan-qing Chen
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%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1600204

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A1 - Jun Ying
A1 - Fan Qu
A1 - Min-yue Dong
A1 - Dan-qing Chen
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Abstract: 
To evaluate the effects of maternal pre-pregnancy body mass index (pre-BMI) and gestational weight gain (GWG) on neonatal birth weight (NBW) in the population of Chinese healthy pregnant women, attempting to guide weight control in pregnancy. A retrospective cohort study of 3772 Chinese women was conducted. The population was stratified by maternal pre-BMI categories as underweight (<18.5 kg/m2), normal weight (18.5–23.9 kg/m2), overweight (24.0–27.9 kg/m2), and obesity (≥28.0 kg/m2). The NBW differences were tested among the four groups, and then deeper associations among maternal pre-BMI, GWG, and NBW were investigated by multivariate analysis. NBW increased significantly with the increase of maternal pre-BMI level (P<0.05), except overweight to obesity (P>0.05). The multivariate analysis showed that both pre-BMI and GWG were positively correlated with NBW (P<0.05). Compared with normal pre-BMI, underweight predicted an increased odds ratio of small-for-gestational-age (SGA) and decreased odds ratio for macrosomia and large-for-gestational-age (LGA), and the results were opposite for overweight. With the increase of GWG, the risk of SGA decreased and the risks of macrosomia and LGA increased. In addition, in different pre-BMI categories, the effects of weight gain in the first trimester on NBW were different (P<0.05). NBW is positively affected by both maternal pre-BMI and GWG, extreme pre-BMI and GWG are both associated with increased risks of abnormal birth weight, and maternal pre-BMI may modify the effect of weight gain in each trimester on NBW. A valid GWG guideline for Chinese women is an urgent requirement, whereas existing recommendations seem to be not very suitable for the Chinese.

孕前体质量指数与孕期增重对新生儿出生体重的影响

目的:评估中国健康孕妇人群中,母亲孕前体质量指数和孕期增重对新生儿出生体重的影响,以期能指导合理的孕期增重。
创新点:选择的人群为健康妊娠的中国孕妇,研究结果可为这一数目庞大的特定人群的孕期甚至孕前体重控制提供一定的理论基础。首次发现了孕前体质量指数可影响孕期各阶段增重与新生儿出生体重之间的关系。
方法:本文做了一个样本为3772例中国孕妇的回顾性研究。根据孕前体质量指数将人群分为四组,分别为低体重组(<18.5 kg/m2)、正常体重组(18.5-23.9 kg/m2)、超重组(24.0-27.9 kg/m2)和肥胖组(≥28.0 kg/m2)。比较这四组间新生儿出生体重 的差异,并用多元分析的方法探究孕前体质量指数、孕期增重和新生儿出生体重之间的关系。
结论:孕妇孕前体质量指数和孕期增重均与新生儿出生体重呈正相关(表2),极端的孕前体质量指数和孕期增重均会增加异常新生儿出生体重的风险(表3);孕期各阶段增重对新生儿出生体重的影响程度可能还受到孕前体质量指数的影响(表2)。对中国妇女来说,已有的孕期增重指南似乎并不十分合适(图2),制定一个有效的指南刻不容缓。

关键词:孕前体质量指数;孕期增重;新生儿出生体重;合理的增重方式

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]Abrams, B., Selvin, S., 1995. Maternal weight gain pattern and birth weight. Obstet. Gynecol., 86(2):163-169.

[2]Alexander, B.T., Dasinger, J.H., Intapad, S., 2014. Effect of low birth weight on women’s health. Clin. Ther., 36(12):1913-1923.

[3]Bayer, O., Ensenauer, R., Nehring, I., et al., 2014. Effects of trimester-specific and total gestational weight gain on children’s anthropometrics. BMC Pregnancy Childbirth, 14:351.

[4]Ditchfield, A.M., Desforges, M., Mills, T.A., et al., 2015. Maternal obesity is associated with a reduction in placental taurine transporter activity. Int. J. Obes., 39(4):557-564.

[5]Ensenauer, R., Chmitorz, A., Riedel, C., et al., 2013. Effects of suboptimal or excessive gestational weight gain on childhood overweight and abdominal adiposity: results from a retrospective cohort study. Int. J. Obes., 37(4):505-512.

[6]Fukuda, S., Tanaka, Y., Harada, K., et al., 2015. Maternal body mass index correlates with the neonatal physique of male infants. Tohoku J. Exp. Med., 237(1):69-75.

[7]Higgins, L., Greenwood, S.L., Wareing, M., et al., 2011. Obesity and the placenta: a consideration of nutrient exchange mechanisms in relation to aberrant fetal growth. Placenta, 32(1):1-7.

[8]Higgins, L., Mills, T.A., Greenwood, S.L., et al., 2013. Maternal obesity and its effect on placental cell turnover. J. Matern.-Fetal Neonatal Med., 26(8):783-788.

[9]Institute of Medicine and National Research Council, 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. The National Academies Press, Washington, DC.

[10]Jancevska, A., Tasic, V., Damcevski, N., et al., 2012. Children born small for gestational age (SGA). Prilozi, 33(2):47-58.

[11]Johnson, M., Campbell, F., Messina, J., et al., 2013. Weight management during pregnancy: a systematic review of qualitative evidence. Midwifery, 29(12):1287-1296.

[12]Johnsson, I.W., Haglund, B., Ahlsson, F., et al., 2015. A high birth weight is associated with increased risk of type 2 diabetes and obesity. Pediatr. Obes., 10(2):77-83.

[13]Kim, S.Y., Sharma, A.J., Sappenfield, W., et al., 2014. Association of maternal body mass index, excessive weight gain, and gestational diabetes mellitus with large-for-gestational-age births. Obstet. Gynecol., 123(4):737-744.

[14]Li, C., Liu, Y., Zhang, W., 2015. Joint and independent associations of gestational weight gain and pre-pregnancy body mass index with outcomes of pregnancy in Chinese women: a retrospective cohort study. PLoS ONE, 10(8):e136850.

[15]Li, N., Liu, E., Guo, J., et al., 2013. Maternal prepregnancy body mass index and gestational weight gain on pregnancy outcomes. PLoS ONE, 8(12):e82310.

[16]Liu, Y., Dai, W., Dai, X., et al., 2012. Prepregnancy body mass index and gestational weight gain with the outcome of pregnancy: a 13-year study of 292 568 cases in China. Arch. Gynecol. Obstet., 286(4):905-911.

[17]March of Dimes, 2010. March of Dimes foundation data book for policy makers: maternal, infant, and child health in the United States (No. 50-2461-10). Office of Government Affairs and March of Dimes, Washington, DC.

[18]Mathews, T.J., MacDorman, M.F., 2011. Infant mortality statistics from the 2007 period linked birth/infant death data set. Natl. Vital Stat. Rep., 59(6):1-30.

[19]McIntire, D.D., Bloom, S.L., Casey, B.M., et al., 1999. Birth weight in relation to morbidity and mortality among newborn infants. N. Engl. J. Med., 340(16):1234-1238.

[20]National Health and Family Planning Commission of the People’s Republic of China, 2011. Management and Specification in Maternal Health Care (in Chinese). http://www.nhfpc.gov.cn/zwgk/wtwj/201304/84ec2d5d37a54398ace49df48ca91c83.shtml

[21]National Health and Family Planning Commission of the People’s Republic of China, 2013. WS/T 428-2013 Criteria of weight for adults. Standards Press of China, Beijing, China (in Chinese).

[22]Negrato, C.A., Gomes, M.B., 2013. Low birth weight: causes and consequences. Diabetol. Metab. Syndr., 5:49.

[23]Sharifzadeh, F., Kashanian, M., Jouhari, S., et al., 2015. Relationship between pre-pregnancy maternal BMI with spontaneous preterm delivery and birth weight. J. Obstet. Gynaecol., 35(4):354-357.

[24]Shin, D., Song, W.O., 2015. Prepregnancy body mass index is an independent risk factor for gestational hypertension, gestational diabetes, preterm labor, and small- and large-for-gestational-age infants. J. Matern.-Fetal Neonatal Med., 28(14):1679-1686.

[25]U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, 2011. Child Health USA 2011. U.S. Department of Health and Human Services, Rockville, Maryland.

[26]Vesco, K.K., Sharma, A.J., Dietz, P.M., et al., 2011. Newborn size among obese women with weight gain outside the 2009 Institute of Medicine recommendation. Obstet. Gynecol., 117(4):812-818.

[27]Wen, T., Lv, Y., 2015. Inadequate gestational weight gain and adverse pregnancy outcomes among normal weight women in China. Int. J. Clin. Exp. Med., 8(2):2881-2886.

[28]Yang, S., Peng, A., Wei, S., et al., 2015. Pre-pregnancy body mass index, gestational weight gain, and birth weight: a cohort study in China. PLoS ONE, 10(6):e130101.

[29]Yang, Y.D., Yang, H.X., 2012. Investigation into the clinical suitability of Institute of Medicine 2009 guidelines regarding weight gain during pregnancy for women with full term singleton fetus in China. Chin. J. Obstet. Gynecol., 47(9):646-650 (in Chinese).

[30]Yu, Z., Han, S., Zhu, J., et al., 2013. Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight/obesity: a systematic review and meta-analysis. PLoS ONE, 8(4):e61627.

[31]Zhang, Z., Kris-Etherton, P.M., Hartman, T.J., 2014. Birth weight and risk factors for cardiovascular disease and type 2 diabetes in US children and adolescents: 10 year results from NHANES. Matern. Child Health J., 18(6):1423-1432.

[32]Zhu, L., Zhang, R., Zhang, S., 2015. Chinese neonatal birth weight curve for different gestational age. Chin. J. Pediatr., 53(2):97-103 (in Chinese).

[33]List of electronic supplementary materials

[34]Fig. S1 Proportions of LBW, macrosomia, SGA, and LGA in neonates from women in the four pre-BMI categories

[35]Table S1 Odds ratios for macrosomia, SGA, and LGA based on total GWG according to the criterions in the four GWG recommendations

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