Overweight, Gestational Weight Gain and Elevated Fasting Plasma Glucose and Their Association with Macrosomia in Chinese Pregnant Women

Abstract

To provide a current estimation of overweight, gestational weight gain(GWG), elevated fasting plasma glucose (FPG) in pregnant women in Kunshan, China and investigate their association with macrosomia using recommendations of IOM and International Association of Diabetes and Pregnancy Study Groups. We conducted a population-based retrospective study and analyzed routine data from Kunshan Maternity and Child Care Surveillance System of 27,322 women with singleton full-term birth from 2006 to 2010. The prevalence of maternal overweight at early pregnancy according to WHO BMI categories (BMI: 25.0-29.9 kg/m(2)) or the cutoffs for Chinese (BMI:24.0-27.9 kg/m(2)), elevated FPG (≥5.1 mmol/L) were estimated. Proportions of women with GWG below, within and above 2009 IOM recommendations were used to evaluate the adequacy of GWG. The association between maternal overweight, GWG, elevated FPG and macrosomia was analyzed by multiple logistic regression. The prevalence of maternal overweight was 8.9 % according to WHO BMI categories and 11.9 % according to Chinese cutoffs. The rate of elevated FPG at first prenatal visit was 19.4 %. Overweight women gained, on average, 12.2 ± 5.3 or 13.0 ± 5.2 (kg) during gestation, 57.1 or 63.93 % of which had excessive weight gain above IOM recommendations (6.8-11.4 kg) according to WHO BMI categories or Chinese cutoffs, respectively. Maternal overweight, GWG and elevated FPG were positively and significantly associated with macrosomia after adjusting for maternal age and gestational weeks at delivery. Maternal overweight, excessive weight gain, elevated FPG are common in the Chinese population in Kunshan. These metabolic risk factors associated with macrosomia should be controlled under the recommendations for Chinese pregnant population.

Prevalence of Macrosomia and Its Risk Factors in China: A Multicentre Survey Based on Birth Data Involving 101 723 Singleton Term Infants

“…The study by Cedergren showed that both elevated pre‐pregnancy weight and excess weight gain conferred risks of fetal macrosomia In the Chinese population, because of the lower prevalence of high maternal BMI compared with developed countries, being overweight or obese does not seem to be the most important contributor to macrosomia. However, obesity has been increasing in recent years . Thus, in the future how to encourage overweight or obese women to get healthy pre‐pregnancy weights and limit excessive weight gain during pregnancy needs more attention from health care providers.…”

Parental Body Mass Index, Gestational Weight Gain, and Risk of Macrosomia: a Population‐Based Case–Control Study in China

“…Macrosomia, defined as a birthweight of more than 4000 g regardless of gestational age, has risen markedly and has become a major public health concern worldwide (including China) throughout the past two decades . A recent hospital‐based, cross‐sectional survey in China reported a prevalence of macrosomia as high as 13.4% in some areas .…”

The evaluation of the low risk pregnant women who gave birth to macrosomic infants

“…Fetal makrozomi riskini arttıran durumlar, önceki çalışmalarda, ileri anne yaşı [4], gebelik öncesi obezite, gebelikte fazla kilo alımı olarak tespit edilmiştir [1,[6][7][8]. Ülkemizde ve Tunus'ta yapılan iki çalışmada, gebelik öncesi VKE arttıkça makrozomik bebek doğurma olasılığının arttığı gösterilmiştir [9,10].…”

“…İran'da ve Çin'de yapılan gestasyonel diyabetli gebeleri hariç tutan iki çalışmada da açlık kan glukozu düzeyleri makrozomik bebek doğuran grupta belirgin olarak yüksek bulunmuştur [8,15]. Ülkemizde yapılan bir araştırma sonucunda, ikinci trimesterdeki 50 gram oral glukoz yüklemesi sonrası 1. saat kan glukoz düzeyleri 130 ile 140 mg/ dL arası olan hastalarda makrozomiyi öngörmede önemli göstergeler, makrozomik doğum öyküsü ve 29-34 gebelik haftaları arasında ölçülen fetal karın çevresi değerleri olarak bulunmuştur [26].…”