Gestational weight gain in Chinese women -- results from a retrospective cohort in Changsha, China

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Abstract

Background

The generalizability of the gestational weight gain (GWG) ranges recommended by the Institute of Medicine (IOM) to Chinese women is disputed.

Methods

In 2016, 16,780 pregnant women who gave birth to live singletons in Changsha, China, were enrolled. First, subjects with optimal pregnancy outcomes were identified for the GWG percentile distribution description and for comparison to the IOM recommendations. Second, all subjects with optimal GWG according to the IOM body mass index (BMI) cutoffs and those with optimal GWG according to the Asian BMI cutoffs were selected. Pregnancy outcomes were compared between those two groups.

Results

A total of 13,717 births with optimal pregnancy outcomes were selected to describe the GWG distribution. The height and central position of the GWG distributions determined by the Asian BMI cutoffs differed from those determined by the IOM BMI cutoffs among the overweight and obese groups. The recommended IOM GWG ranges were narrower than and shifted to the left of the observed distributions. In both BMI classification schemes, however, the IOM-recommended ranges were within the middle 70% (Pc 15th–85th) and 50% (Pc 25th–75th) of the observed distribution. A total of 6438 (38.37%) and 6110 (36.41%) women gained optimal GWG, according to the IOM and Asian BMI classifications, respectively. Compared with those with optimal GWG according to IOM BMI cutoffs, women with optimal GWG according to the Asian BMI cutoffs had lower risks of both macrosomia (adjusted OR = 0.79, 95%CI: 0.67–0.94) and large-for-gestational age (adjusted OR = 0.86, 95%CI: 0.76, 0.98). However, no significantly different risks of preterm, low birthweight, small-for-gestational age, pregnancy-induced hypertension, or gestational diabetes were found between them.

Conclusions

The IOM-recommended GWG ranges are within the middle 70% of the distributions in Chinese women, and pre-pregnancy weight status should be determined by the Asian BMI cut-off points for monitoring and making GWG recommendations to Chinese women.

Electronic supplementary material

The online version of this article (10.1186/s12884-018-1833-y) contains supplementary material, which is available to authorized users.

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Most cited references 21

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Birth Weight Reference Percentiles for Chinese

Li-Chun Dai, Changfei Deng, Yanhua Li … (2014)

Objective To develop a reference of population-based gestational age-specific birth weight percentiles for contemporary Chinese. Methods Birth weight data was collected by the China National Population-based Birth Defects Surveillance System. A total of 1,105,214 live singleton births aged ≥28 weeks of gestation without birth defects during 2006–2010 were included. The lambda-mu-sigma method was utilized to generate percentiles and curves. Results Gestational age-specific birth weight percentiles for male and female infants were constructed separately. Significant differences were observed between the current reference and other references developed for Chinese or non-Chinese infants. Conclusion There have been moderate increases in birth weight percentiles for Chinese infants of both sexes and most gestational ages since 1980s, suggesting the importance of utilizing an updated national reference for both clinical and research purposes.

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The accuracy of self-reported pregnancy-related weight: a systematic review.

I Headen, A. K. COHEN, M. Mujahid … (2017)

Self-reported maternal weight is error-prone, and the context of pregnancy may impact error distributions. This systematic review summarizes error in self-reported weight across pregnancy and assesses implications for bias in associations between pregnancy-related weight and birth outcomes. We searched PubMed and Google Scholar through November 2015 for peer-reviewed articles reporting accuracy of self-reported, pregnancy-related weight at four time points: prepregnancy, delivery, over gestation and postpartum. Included studies compared maternal self-report to anthropometric measurement or medical report of weights. Sixty-two studies met inclusion criteria. We extracted data on magnitude of error and misclassification. We assessed impact of reporting error on bias in associations between pregnancy-related weight and birth outcomes. Women underreported prepregnancy (PPW: -2.94 to -0.29 kg) and delivery weight (DW: -1.28 to 0.07 kg), and over-reported gestational weight gain (GWG: 0.33 to 3 kg). Magnitude of error was small, ranged widely, and varied by prepregnancy weight class and race/ethnicity. Misclassification was moderate (PPW: 0-48.3%; DW: 39.0-49.0%; GWG: 16.7-59.1%), and overestimated some estimates of population prevalence. However, reporting error did not largely bias associations between pregnancy-related weight and birth outcomes. Although measured weight is preferable, self-report is a cost-effective and practical measurement approach. Future researchers should develop bias correction techniques for self-reported pregnancy-related weight.

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A revised birth weight reference for the United States.

Elaine Duryea, Josiah S. Hawkins, Donald D. McIntire … (2014)

To generate birth weight curves based on the obstetric estimate of gestational age as specified in the revised 2003 U.S. birth certificate. Using National Center for Health Statistics data from 2011, we constructed birth weight curves for neonates between 24 and 42 weeks of gestation. Curves were developed using the obstetric estimate of gestational age that is included in the revised 2003 U.S. birth certificate, which, when available, incorporates ultrasound dating information. Live-born singleton neonates between 500 and 6,000 g without malformations were included. These curves were compared with curves we generated using 1991 data on which the current national reference of Alexander and colleagues is based, a reference that used only last menstrual period to establish gestational age. The 1991 curves were based on 3,684,778 U.S. live births and the 2011 on 3,252,011 births. Birth weight percentile values were greater from 28 to 36 weeks of gestation in the 1991 data set. That is, the birth weights for preterm neonates were overestimated when 1991 reference curves were used compared with the proposed 2011 reference. For example, in 1991, a birth weight of 2,000 g was at the 50th percentile between 31 and 32 weeks of gestation, whereas in 2011, a birth weight of 2,000 g now corresponds to the 50th percentile between 33 and 34 weeks of gestation. Our revised reference curve for the United States provides an updated national reference for birth weight. : II.

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Author and article information

Contributors

Xin Huang: xin.huang@hunnu.edu.cn

Hongzhuan Tan: tanhz99@qq.com

Ming Cai: 1005546543@qq.com

Ting Shi: kcxh@qq.com

Chunmei Mi: 86-18975186168 , 615871972@qq.com

Jun Lei:

ORCID: http://orcid.org/0000-0003-3192-9560

86-18975186168 , junlei.xy3yy@hotmail.com

Journal

Journal ID (nlm-ta): BMC Pregnancy Childbirth

Journal ID (iso-abbrev): BMC Pregnancy Childbirth

Title: BMC Pregnancy and Childbirth

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2393

Publication date (Electronic): 29 May 2018

Publication date PMC-release: 29 May 2018

Publication date Collection: 2018

Volume: 18

Electronic Location Identifier: 185

Affiliations

[1 ]ISNI 0000 0001 0089 3695, GRID grid.411427.5, Department of Preventive Medicine, School of Medicine, , Hunan Normal University, ; Changsha, Hunan China

[2 ]ISNI 0000 0001 0379 7164, GRID grid.216417.7, Department of Epidemiology and Health Statistics, Xiangya School of Public Health, , Central South University, ; Changsha, Hunan China

[3 ]Maternity and Child Care Hospital of Yuelu District, Changsha, Hunan China

[4 ]Maternity and Child Care Hospital of Tianxin District, Changsha, Hunan China

[5 ]GRID grid.431010.7, Department of Obstetrics and Gynecology, , The Third Xiangya Hospital of Central South University, ; 138 Tongzipo Road, Yuelu District, Changsha, 410013 Hunan, Province China

Author information

Jun Lei http://orcid.org/0000-0003-3192-9560

Article

Publisher ID: 1833

DOI: 10.1186/s12884-018-1833-y

PMC ID: 5975263

PubMed ID: 29843642

SO-VID: 1399bb41-6c15-4406-8a93-19e9c3cfcc50

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 21 January 2018

Date accepted : 17 May 2018

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100004735, Natural Science Foundation of Hunan Province;

Award ID: 2017JJ3215

Award Recipient : Xin Huang

Funded by: Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University

Award ID: GMU-2017-005

Award Recipient : Xin Huang

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ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: body mass index,gestational weight gain,chinese women,pregnancy

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ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: body mass index, gestational weight gain, chinese women, pregnancy

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Gestational weight gain in Chinese women -- results from a retrospective cohort in Changsha, China

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Abstract

Background

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Conclusions

Electronic supplementary material

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Karger: Nutrition and Dietetics

Most cited references 21

Birth Weight Reference Percentiles for Chinese

The accuracy of self-reported pregnancy-related weight: a systematic review.

A revised birth weight reference for the United States.

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Cited by 12

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