Estimated optimal gestational weight gain for pregnant women with gestational diabetes mellitus: a prospective cohort study in China

Cheng, Zhihao; Wei, Yueguang; Li, Hongtian; Yu, Hong-Zhao; Zhou, Yubo; Liu, Jianmeng

doi:10.1038/s41430-022-01238-8

Cited by 3 publications

(4 citation statements)

References 43 publications

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“…Several studies 38 , 39 modelling the optimal GWG were merely based on fetal growth outcome such as LGA and SGA, however, seldom highlighted maternal adverse outcomes. The optimal GWG for GDM women developed by Cheng et al 40 that based on LGA and SGA solely was higher than the GWG proposed by Fan et al 41 that was on account of various pregnancy outcomes. This illustrated that fewer adverse outcomes were considered, the greater potential of gaining excessive GWG.…”

Section: Discussionmentioning

confidence: 78%

“…Bogdanet et al 18 suggested that GWG ranges recommended by the NAM were too much for GDM women. Confirmed it, another original study 19 that explored the GDM-specific optimal GWG of Chinese women illustrated that the optimal GWG for women with normal weight and obesity were both lower than NAM recommendations. Collectively, GWG guidelines for Chinese women with GDM should be proposed specially and separately based on different pre-pregnancy BMI category.…”

Section: Introductionmentioning

confidence: 91%

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The exploration of optimal gestational weight gain after oral glucose tolerance test for Chinese women with gestational diabetes mellitus

Zheng,

Zhu,

Jiang

et al. 2024

Sci Rep

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Now, no recommendations of gestational weight gain (GWG) after gestational diabetes mellitus (GDM) diagnosis for Chinese women was made. This study aimed to explore the optimal GWG after oral glucose tolerance test (OGTT) for Chinese women with GDM. The GWG status of 11,570 women was retrospectively analyzed. Binary regression model and restricted cubic spline were used to estimate the association between GWG after OGTT and the predicted probability of adverse outcomes. Based on above, the optimal GWG was defined as the range that not exceed 1% increase in the predicted probability from the lowest point. Results shown that every increased one unit GWG after OGTT was associated with higher risks of macrosomia, cesarean section and LGA, and lower risk of preterm birth. According to the WHO and Working Group on Obesity in China (WGOC) recommended pre-pregnancy BMI category, the optimal GWG were proposed: 3.66 to 6.66 kg/3.66 to 6.66 kg in underweight group, 3.07 to 6.50 kg/3.02 to 6.40 kg in normal weight group, 1.06 to 2.73 kg/0 to 1.99 kg in overweight group, and not applicable/− 0.22 to 2.53 kg in obese group, respectively. Therefore, it is necessary to classified Chinese population based on the WGOC recommended pre-pregnancy BMI category, that influenced the contribution of pre-pregnancy BMI groups and the optimal GWG recommendation for GDM women with overweight or obesity.

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Section: Discussionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 91%

The exploration of optimal gestational weight gain after oral glucose tolerance test for Chinese women with gestational diabetes mellitus

Zheng,

Zhu,

Jiang

et al. 2024

Sci Rep

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show abstract

“… 55 To date, no consensus on recommendations for Chinese women with GDM has been achieved. Cheng et al 56 explored the suggested GWG ranges for Chinese women with GDM, that is, 9.5–14.0 kg for normal-weight and 3.0–7.5 kg for overweight women. Inconsistent with the above conclusion, another study suggested the following optimal GWG ranges for Chinese women with GDM: 11.0–17.5 kg for underweight women, 3.7–9.7 kg for normal-weight women, −0.6 to 4.8 kg for overweight women and −9.8 to 4.2 kg for obese women.…”

Section: Discussionmentioning

confidence: 99%

Association between prepregnancy body mass index or gestational weight gain and adverse pregnancy outcomes among Chinese women with gestational diabetes mellitus: a systematic review and meta-analysis

Zhu,

Zheng,

Pan

et al. 2024

BMJ Open

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ObjectiveThe association between prepregnancy body mass index (BMI) or gestational weight gain (GWG) and adverse pregnancy outcomes among Chinese women with gestational diabetes mellitus (GDM) is unknown. This study aims to evaluate such association by synthesising the evidence.DesignSystematic review and meta-analysis.Data sourcesPubMed, Web of Science, Scopus, EMBASE, China Biology Medicine disc, China National Knowledge Infrastructure, Wangfang, and China Science and Technology Journal Database searched from inception to 11 August 2023.Eligibility criteriaProspective cohort studies, retrospective cohort studies and case–control studies estimating the relationship of abnormal prepregnancy BMI (including underweight, overweight or obesity) or inappropriate GWG (including excess GWG or insufficient GWG) with adverse pregnancy outcomes of interest were included. Outcomes included macrosomia, caesarean section, preterm birth, gestational hypertension, large for gestational age (LGA) and small for gestational age (SGA).Data extraction and synthesisTwo reviewers independently selected studies, extracted the data and assessed the risk of bias. OR estimate and its 95% CI were pooled using Stata software fixed-effect model. Subgroup analysis, meta-regression and sensitivity analysis were performed to ensure credibility of the results.ResultsTwenty-three studies (eighteen retrospective cohort studies, three prospective cohort studies and two case control studies) involving 57 013 Chinese women with GDM were identified. Meta-analysis results showed that compared with GDM women with normal weight, GDM women with underweight were at a higher risk of SGA (OR=1.79 (1.54 to 2.07), five studies involving 31 967 women); women with overweight had higher risks of macrosomia (OR=1.65 (1.49 to 1.82), eleven studies involving 41 683 women), caesarean section (OR=1.48 (1.38 to 1.59), ten studies involving 34 935 women), preterm birth (OR=1.27 (1.13 to 1.43), eight studies involving 38 295 women) and LGA (OR=1.73 (1.54 to 1.95), seven studies involving 31 342 women) and women with obesity had higher risks of macrosomia (OR=2.37 (2.04 to 2.76), eleven studies involving 41 683 women), caesarean section (OR=2.07 (1.84 to 2.32), nine studies involving 34 829 women), preterm birth (OR=1.31 (1.09 to 1.57), eight studies involving 38 295 women) and LGA (OR=2.63 (2.15 to 3.21), six studies involving 31 236 women). Regard to GWG, compared with Chinese GDM women with sufficient GWG, GDM women with excessive GWG had higher risks of macrosomia (OR=1.74 (1.58 to 1.92), twelve studies involving 40 966 women), caesarean section (OR=1.44 (1.36 to 1.53), nine studies involving 36 205 women) and LGA (OR=2.12 (1.96 to 2.29), twelve studies involving 42 342 women); women with insufficient GWG conversely had higher risks of preterm birth (OR=1.59 (1.45 to 1.74), nine studies involving 37 461 women) and SGA (OR=1.38 (1.27 to 1.51), ten studies involving 41 080 women).ConclusionsFor Chinese women with GDM, abnormal prepregnancy BMI or inappropriate GWG were related to higher risks of many adverse pregnancy outcomes. Therefore, medical staff should pay more attention to the weight management of GDM women during pregnancy.

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“…exploration of optimal range in China and abroad have supported stricter optimal GWG ranges than the NAM standards to improve pregnancy outcomes (10)(11). Considering the great impact of GWG during the second and third trimesters on adverse outcomes, proposing an optimal GWG after diagnosis of GDM rather than the total GWG allows clinicians to give targeted suggestions and counsel their patients on their weekly GWG regarding their weight control performance.…”

Section: China Cdc Weeklymentioning

confidence: 99%

Optimal Gestational Weight Gain for Women with Gestational Diabetes Mellitus — China, 2011–2021

Lyu¹,

Yin²,

Ji³

et al. 2023

China CDC Weekly

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What is already known about this topic?Joint effects of gestational weight gain (GWG) and hyperglycemia on adverse pregnancy outcomes suggest that lower optimal GWG is optimal for women with gestational diabetes mellitus (GDM). However, there is still a lack of guidelines. What is added by this report?Optimal weekly GWG range after diagnosis of GDM for underweight, normal-weight, overweight, and obese women was 0.37-0.56 kg/week, 0.26-0.48 kg/week, 0.19-0.32 kg/week, and 0.12-0.23 kg/week, respectively. What are the implications for public health practice?The findings may be used to inform prenatal counseling regarding optimal gestational weight gain for women with gestational diabetes mellitus, and suggest the need for weight gain management.

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Estimated optimal gestational weight gain for pregnant women with gestational diabetes mellitus: a prospective cohort study in China

Cited by 3 publications

References 43 publications

The exploration of optimal gestational weight gain after oral glucose tolerance test for Chinese women with gestational diabetes mellitus

The exploration of optimal gestational weight gain after oral glucose tolerance test for Chinese women with gestational diabetes mellitus

Association between prepregnancy body mass index or gestational weight gain and adverse pregnancy outcomes among Chinese women with gestational diabetes mellitus: a systematic review and meta-analysis

Optimal Gestational Weight Gain for Women with Gestational Diabetes Mellitus — China, 2011–2021

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