Gestational weight gain and adverse pregnancy outcomes: a prospective cohort study
Objective To assess the associations of gestational weight gain (GWG) in early and late pregnancy with subsequent risks of adverse pregnancy outcomes in Chinese women.Design Prospective cohort study.Setting Shanghai, China.Participants We studied 2630 nulliparous singleton pregnant women with comple...
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e038187.full |
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| author | Jun Zhang Yuelin Wu Sheng Wan Shengyi Gu Zhengqian Mou Lingling Dong Zhongcheng Luo Xiaolin Hua |
| author_facet | Jun Zhang Yuelin Wu Sheng Wan Shengyi Gu Zhengqian Mou Lingling Dong Zhongcheng Luo Xiaolin Hua |
| author_sort | Jun Zhang |
| collection | DOAJ |
| description | Objective To assess the associations of gestational weight gain (GWG) in early and late pregnancy with subsequent risks of adverse pregnancy outcomes in Chinese women.Design Prospective cohort study.Setting Shanghai, China.Participants We studied 2630 nulliparous singleton pregnant women with complete data on weight gain in early (≤17 weeks of gestation) and late (>17 weeks) pregnancy in the Shanghai Birth Cohort.Methods GWG was standardised into z-scores by gestational age and categorised as low (z-score <−1), normal (−1 to +1) and high (>1). The adjusted relative risks (aRRs) and 95%CIs were estimated through log-binomial regression models. Interaction effects between GWG and some other adjustment factors were tested, further stratified analyses were performed separately where interaction terms were significant.Outcome measures Adverse maternal and neonatal outcomes.Results Independent from GWG in late pregnancy, higher GWG in early pregnancy was associated with higher risks of gestational diabetes mellitus (aRR: 1.66; 95% CI: 1.11 to 2.48), caesarean section (aRR: 1.21; 95% CI: 1.05 to 1.39) and prolonged hospitalisation (aRR: 1.56; 95% CI: 1.03 to 2.38). Higher GWG in late pregnancy was independently associated with higher risks of caesarean section (aRR: 1.24; 95% CI: 1.09 to 1.41), large for gestational age (aRR: 2.01; 95% CI: 1.50 to 2.7) and macrosomia (aRR: 1.90; 95% CI: 1.30 to 2.78). In addition, the risk of gestational hypertension increased significantly with increased total GWG (aRR: 1.78; 95% CI: 1.14 to 2.76). The effects of GWG in late pregnancy on maternal and neonatal outcomes were significantly different between the women bearing a female and the women bearing male fetus.Conclusion The GWG associations with adverse pregnancy outcomes differ at early and late pregnancy, and there may be effect modification by fetal sex in the association of GWG in late pregnancy with some pregnancy outcomes. |
| format | Article |
| id | doaj-art-863b91fd8ff2430e80b75bec1c1a82b7 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-863b91fd8ff2430e80b75bec1c1a82b72025-01-07T13:20:13ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-038187Gestational weight gain and adverse pregnancy outcomes: a prospective cohort studyJun Zhang0Yuelin Wu1Sheng Wan2Shengyi Gu3Zhengqian Mou4Lingling Dong5Zhongcheng Luo6Xiaolin Hua7Ministry of Education-Shanghai Key Laboratory of Children`s Environmental Health, Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China1 Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Shanghai, China1 Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Shanghai, China2 Department of Obstetrics and Gynaecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China2 Department of Obstetrics and Gynaecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China1 Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China3 Obstetrics and Gynaecology, Mount Sinai Hospital, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, CanadaDepartment of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, ChinaObjective To assess the associations of gestational weight gain (GWG) in early and late pregnancy with subsequent risks of adverse pregnancy outcomes in Chinese women.Design Prospective cohort study.Setting Shanghai, China.Participants We studied 2630 nulliparous singleton pregnant women with complete data on weight gain in early (≤17 weeks of gestation) and late (>17 weeks) pregnancy in the Shanghai Birth Cohort.Methods GWG was standardised into z-scores by gestational age and categorised as low (z-score <−1), normal (−1 to +1) and high (>1). The adjusted relative risks (aRRs) and 95%CIs were estimated through log-binomial regression models. Interaction effects between GWG and some other adjustment factors were tested, further stratified analyses were performed separately where interaction terms were significant.Outcome measures Adverse maternal and neonatal outcomes.Results Independent from GWG in late pregnancy, higher GWG in early pregnancy was associated with higher risks of gestational diabetes mellitus (aRR: 1.66; 95% CI: 1.11 to 2.48), caesarean section (aRR: 1.21; 95% CI: 1.05 to 1.39) and prolonged hospitalisation (aRR: 1.56; 95% CI: 1.03 to 2.38). Higher GWG in late pregnancy was independently associated with higher risks of caesarean section (aRR: 1.24; 95% CI: 1.09 to 1.41), large for gestational age (aRR: 2.01; 95% CI: 1.50 to 2.7) and macrosomia (aRR: 1.90; 95% CI: 1.30 to 2.78). In addition, the risk of gestational hypertension increased significantly with increased total GWG (aRR: 1.78; 95% CI: 1.14 to 2.76). The effects of GWG in late pregnancy on maternal and neonatal outcomes were significantly different between the women bearing a female and the women bearing male fetus.Conclusion The GWG associations with adverse pregnancy outcomes differ at early and late pregnancy, and there may be effect modification by fetal sex in the association of GWG in late pregnancy with some pregnancy outcomes.https://bmjopen.bmj.com/content/10/9/e038187.full |
| spellingShingle | Jun Zhang Yuelin Wu Sheng Wan Shengyi Gu Zhengqian Mou Lingling Dong Zhongcheng Luo Xiaolin Hua Gestational weight gain and adverse pregnancy outcomes: a prospective cohort study BMJ Open |
| title | Gestational weight gain and adverse pregnancy outcomes: a prospective cohort study |
| title_full | Gestational weight gain and adverse pregnancy outcomes: a prospective cohort study |
| title_fullStr | Gestational weight gain and adverse pregnancy outcomes: a prospective cohort study |
| title_full_unstemmed | Gestational weight gain and adverse pregnancy outcomes: a prospective cohort study |
| title_short | Gestational weight gain and adverse pregnancy outcomes: a prospective cohort study |
| title_sort | gestational weight gain and adverse pregnancy outcomes a prospective cohort study |
| url | https://bmjopen.bmj.com/content/10/9/e038187.full |
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