Association between maternal gestational weight gain and preterm birth according to body mass index and maternal age in Quzhou, China

Abstract

The aim of this study is to investigate the association between maternal gestational weight gain (GWG) and preterm birth according to pre-pregnancy body mass index (BMI) and maternal age. We did a cohort, hospital-based study in Quzhou, South China, from 1 Jan 2018 to 30 June 2019. We selected 4274 singleton live births in our analysis, 315 (7.4%) of which were preterm births. In the overall population, excess GWG was significantly associated with a decreased risk of preterm birth compared with adequate GWG (adjusted OR 0.81 [95% CI 0.72–0.91]), and the risk varied by increasing maternal age and pre-pregnancy BMI. Interestingly, underweight women who older than 35 years with excess GWG had significantly increased odds of preterm birth compared with adequate GWG in underweight women aged 20–29 years (2.26 [1.06–4.85]) and normal weight women older than 35 years (2.23 [1.13–4.39]). Additionally, low GWG was positively and significantly associated with preterm birth overall (1.92 [1.47–2.50]). Among normal weight women category, compared with adequate GWG women aged 20–29 years did, those older than 20 years with low GWG, had significantly higher odds of preterm birth, which increased with maternal age (1.80 [1.16–2.79] in 20–29 years, 2.19 [1.23–3.91] in 30–34 years, 3.30 [1.68–6.46] in ≫ 35 years). In conclusion, maternal GWG was significantly associated with the risk of preterm birth, but the risk varied by pre-pregnancy BMI and maternal age.

The Rate of Gestational Weight Gain are Associated with Preterm Birth in Pregnant Women at Low Risk for Preterm Birth: A Single-Center, Observational Study

“…As in most previous studies, we found that insufficient GWG significantly increased the risk of PTB, especially among pregnant women classified as underweight or normal weight. We did not find an association between excessive rate of GWG and PTB risk; however, the risk increased if women had a low PP-BMI, which is consistent with some studies [11,25]. Although the biological mechanism is not clear, it can be considered that a reasonable GWG during pregnancy can effectively reduce the risk of PTB, especially for pregnant women with low PP-BMI.…”

“…First, given the potential confounding bias, our study used a cohort of motherchild pairs with a one-and-a-half-year follow-up, and only women lacking undisputed high-risk factors for PTB were included in the study. Several studies used retrospective designs to investigate the association between GWG and PTB, which maybe a source of bias [25][26][27]. While most previous studies used statistical methods to correct for research bias caused by other high-risk factors of PTB, we excluded the PTB high-risk group from the beginning of the cohort study to accurately describe the relationship between GWG and PTB.…”

The Association between Dietary Patterns and Pre-Pregnancy BMI with Gestational Weight Gain: The “Born in Shenyang” Cohort

“…Participants reported their pre-pregnancy weight (kg) at the time of enrollment and trained obstetricians measured weight during pregnancy a median of 10 times (range, [5][6][7][8][9][10][11][12][13][14][15][16][17]. The obstetricians measured each participant's weight twice and calculated the average value of the two measurements.…”

“…The epidemic of excessive gestational weight gain (EGWG) during recent decades has led to a high incidence of adverse maternal and child health outcomes, such as gestational diabetes mellitus, cesarean delivery, and childhood obesity [1][2][3][4]. The prevalence of EGWG in China varies from 27.5−44.5% based on the geographic region [5,6] and has become a serious public health concern.…”

Effect of gestational weight gain on postpartum pelvic floor function in twin primiparas: a single-center retrospective study in China

“…With the increase in gestational age, GWG is a normal physiological process of pregnancy development [13]. Adequate GWG can reduce the incidence of maternal and neonatal complications [14][15][16]. In 2009, the Institute of Medicine (IOM) published GMG guidelines and developed different criteria for GWG of singleton and twin pregnant women to promote GWG control in the normal range [17].…”