Investigation of optimal gestational weight gain based on the occurrence of adverse pregnancy outcomes for Chinese women: a prospective cohort study

Yin Sun, Zhongzhou Shen, Yongle Zhan, Yawen Wang, Shuai Ma, Suhan Zhang, Juntao Liu, Sansan Wu, Yahui Feng, Yunli Chen, Shuya Cai, Yingjie Shi, Liangkun Ma, Yu Jiang, Yin Sun, Zhongzhou Shen, Yongle Zhan, Yawen Wang, Shuai Ma, Suhan Zhang, Juntao Liu, Sansan Wu, Yahui Feng, Yunli Chen, Shuya Cai, Yingjie Shi, Liangkun Ma, Yu Jiang

Abstract

Objective: To investigate recommendations for appropriate gestational weight gain (GWG) of Chinese females.

Methods: In total of 3,172 eligible women in the first trimester were recruited into the Chinese Pregnant Women Cohort Study (CPWCS) project. Pregnancy complications and outcomes were collated using the hospital medical records system. The method of occurrence of participants with adverse pregnancy outcomes (Occurrence Method) was conducted to calculate the recommended total GWG for each participant's pre-pregnancy BMI. Occurrence Method data were judged against the Institute of Medicine (IOM) and Japanese recommended criteria in terms of the total occurrence of adverse pregnancy outcomes of pregnant women with appropriate weight gain.

Results: The most frequent GWG was ≥ 14 kg and < 16 kg (19.4%), followed by ≥ 10 kg and < 12 kg (15.5%) and ≥ 12 kg and < 14 kg (15.2%). The most frequently occurring adverse pregnancy outcomes were cesarean sections for underweight (30.0%), normal weight (40.4%), overweight (53.6%) and obese (53.7%) women. A large for gestational age (LGA) accounted for 18.0% of the overweight and 20.9% of the obesity group. Gestational diabetes mellitus (GDM) occurred in 16.9% of overweight and 23.1% of obese women. The recommended total GWG in a Chinese women population is ≥ 8 and < 12 kg if underweight, ≥ 12 and < 14 kg for normal weight, ≥ 8.0 and < 10.0 kg if overweight, and < 8 kg for women with obesity.

Conclusions: Current Chinese recommendations provide the optimal ranges of GWG to minimize the occurrence of undesirable pregnancy outcomes for each group of pre-pregnancy BMIs in a Chinese population.

Trial registration: Registered with ClinicalTrials ( NCT03403543 ).

Keywords: Chinese pregnant women; Cohort study; Gestational weight gain; Pre-pregnancy BMI; Recommendations.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Flowchart of the Occurrence Method
Fig. 2
Fig. 2
The algorithm of evaluation and comparison of different recommended GWGs. Note: GWG: gestational weight gain
Fig. 3
Fig. 3
Distribution of pre-pregnancy BMI (A) and gestational weight gain (B) of the study population

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