Skip to main content
Log in

Prepregnancy body mass index and gestational weight gain with the outcome of pregnancy: a 13-year study of 292,568 cases in China

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

We aimed to investigate the combined associations of prepregnancy body mass index (BMI) and gestational weight gain (GWG) with pregnancy outcomes in Chinese women.

Methods

Data for 292,568 singleton term pregnancies were selected from 1993 to 2005 based on the Perinatal Health Care Surveillance System, with anthropometric measurements being collected prospectively. Prepregnancy BMI was categorized according to the definitions of the World Health Organization (WHO). Total GWG was categorized into four groups. Adjusted associations of prepregnancy BMI and GWG with outcomes of interest were estimated using logistic regression analyses. GWG was categorized as below, within and above the Institute of Medicine (IOM) (2009) recommendations.

Results

Maternal overweight and high GWG or GWG above the IOM recommendation were associated with hypertensive disorders complicating pregnancy, cesarean delivery, macrosomia and large-for-gestational-age (LGA) infants. Maternal underweight and low GWG or GWG below the IOM recommendation were risk factors for low-birth-weight (LBW) and small-for-gestational-age (SGA) infants. Moreover, being overweight [odds ratio (OR) 1.2, 95 % confidence interval (CI) 1.0–1.3) and having a low weight gain (OR 1.1, 95 % CI 1.0–1.1) increased the risk of newborn asphyxia.

Conclusion

Being overweight/obese and having a high weight gain, as well as being underweight and having a low weight gain, were associated with increased risks for adverse pregnancy outcomes in Chinese women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Berry RJ, Li Z, Erickson JD et al (1999) Prevention of neural-tube defects with folic acid in China. China-U.S. Collaborative Project for Neural Tube Defect Prevention. N Engl J Med 341:1485–1490

    Article  CAS  PubMed  Google Scholar 

  2. Cedergren M (2006) Effects of gestational weight gain and body mass index on obstetric outcome in Sweden. Int J Gynaecol Obstet 93:269–274

    Article  CAS  PubMed  Google Scholar 

  3. Cedergren MI (2007) Optimal gestational weight gain for body mass index categories. Obstet Gynecol 110:764

    Article  Google Scholar 

  4. Chen Z, Du J, Shao L et al (2010) Prepregnancy body mass index, gestational weight gain, and pregnancy outcomes in China. Int J Gynaecol Obstet 109:41–44

    Article  PubMed  Google Scholar 

  5. Cnattingius S, Bergstrom R, Lipworth L, Kramer MS (1998) Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med 338:147–152

    Article  CAS  PubMed  Google Scholar 

  6. Institute of Medicine (1990) Nutrition during pregnancy: part i, weight gain: part ii, nutrient supplements. National Academy Press, Washington, DC

    Google Scholar 

  7. Institute of Medicine (2009) Weight gain during pregnancy: reexamining the guidelines. The National Academies Press, Washington, DC

    Google Scholar 

  8. Jensen DM, Ovesen P, Beck-Nielsen H et al (2005) Gestational weight gain and pregnancy outcomes in 481 obese glucose-tolerant women. Diabet Care 28:2118–2122

    Article  Google Scholar 

  9. Joseph KS, Young DC, Dodds L et al (2003) Changes in maternal characteristics and obstetric practice and recent increases in primary cesarean delivery. Obstet Gynecol 102:791–800

    Article  CAS  PubMed  Google Scholar 

  10. Kim SY, Dietz PM, England L, Morrow B, Callaghan WM (2007) Trends in pre-pregnancy obesity in nine states, 1993–2003. Obesity (Silver Spring) 15:986–993

    Article  Google Scholar 

  11. Li S, Moore CA, Li Z et al (2003) A population-based birth defects surveillance system in the People’s Republic of China. Paediatr Perinat Epidemiol 17:287–293

    Article  PubMed  Google Scholar 

  12. Ma GS, Li YP, Wu YF et al (2005) The prevalence of body overweight and obesity and its changes among Chinese people during 1992 to 2002. Zhonghua Yu Fang Yi Xue Za Zhi 39:311–315

    PubMed  Google Scholar 

  13. Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP (1999) The spread of the obesity epidemic in the United States, 1991–1998. JAMA 282:1519–1522

    Article  CAS  PubMed  Google Scholar 

  14. Nohr EA, Bech BH, Vaeth M, Rasmussen KM, Henriksen TB, Olsen J (2007) Obesity, gestational weight gain and preterm birth: a study within the Danish National Birth Cohort. Paediatr Perinat Epidemiol 21:5–14

    Article  PubMed  Google Scholar 

  15. Nohr EA, Vaeth M, Baker JL, TIa S, Olsen J, Rasmussen KM (2008) Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. Am J Clin Nutr 87:1750–1759

    CAS  PubMed  Google Scholar 

  16. Sherrard A, Platt RW, Vallerand D, Usher RH, Zhang X, Kramer MS (2007) Maternal anthropometric risk factors for caesarean delivery before or after onset of labour. BJOG 114:1088–1096

    Article  CAS  PubMed  Google Scholar 

  17. Stotland NE, Cheng YW, Hopkins LM, Caughey AB (2006) Gestational weight gain and adverse neonatal outcome among term infants. Obstet Gynecol 108:635–643

    Article  PubMed  Google Scholar 

  18. Stotland NE, Hopkins LM, Caughey AB (2004) Gestational weight gain, macrosomia, and risk of cesarean birth in nondiabetic nulliparas. Obstet Gynecol 104:671–677

    Article  PubMed  Google Scholar 

  19. Thorsdottir I, Torfadottir JE, Birgisdottir BE, Geirsson RT (2002) Weight gain in women of normal weight before pregnancy: complications in pregnancy or delivery and birth outcome. Obstet Gynecol 99:799–806

    Article  PubMed  Google Scholar 

  20. Vahratian A, Siega-Riz AM, Savitz DA, Zhang J (2005) Maternal pre-pregnancy overweight and obesity and the risk of cesarean delivery in nulliparous women. Ann Epidemiol 15:467–474

    Article  PubMed  Google Scholar 

  21. Young TK, Woodmansee B (2002) Factors that are associated with cesarean delivery in a large private practice: the importance of prepregnancy body mass index and weight gain. Am J Obstet Gynecol 187:312–318 (discussion 318–320)

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors have no potential conflicts of interest to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Zhu Li.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Liu, Y., Dai, W., Dai, X. et al. 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, 905–911 (2012). https://doi.org/10.1007/s00404-012-2403-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-012-2403-6

Keywords

Navigation