Tianjin Women's and Children's Health Center, Tianjin, People's Republic of China.
NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People's Republic of China.
Public Health Nutr. 2023 Oct;26(10):2005-2013. doi: 10.1017/S1368980023001490. Epub 2023 Aug 14.
To identify the optimal weight gain at the end of the second trimester.
This was a population-based cohort study from the antenatal care system in Tianjin, China. We calculated gestational weight gain (GWG) based on the weight measured in the first trimester and the end of the second trimester. Restricted cubic spline analysis was performed to model the possible non-linear relationships between GWG and adverse outcomes. The optimal GWG was defined as the value of the lowest risk. Non-inferiority margins and the shape of the spline curves identified the recommended ranges in Chinese-specific BMI categories.
Tianjin Maternal and Child Health Cohort.
Singleton pregnant women aged 18-45 years.
In total, 69 859 pregnant women were included. Adverse outcome (including stillbirth, preterm birth, hypertensive disorders of pregnancy, gestational diabetes mellitus, small and large for gestational age) was significantly associated with GWG at the end of the second trimester. The risk score was non-linearly correlated with GWG in the underweight, normal weight and overweight groups. GWG at the end of the second trimester should not be < 7 kg in underweight group. For most normal-weight women, a GWG of about 8 kg is optimal. Pregnant women who are overweight should not have a GWG of more than 9 kg. We advised women with overweight and obesity to keep positive growth of GWG (> 0 kg) in the first and second trimesters.
According to the comprehensive adverse maternal and infant outcomes, we recommend the optimal GWG at the end of the second trimester. This study may provide a considerable reference for weight management.
确定孕中期末最佳体重增加量。
这是一项基于人群的队列研究，来自中国天津的产前保健系统。我们根据孕早期和孕中期末测量的体重计算了妊娠体重增加（GWG）。限制性立方样条分析用于建立 GWG 与不良结局之间可能的非线性关系。最佳 GWG 定义为风险最低的数值。非劣效性边界和样条曲线的形状确定了中国特定 BMI 类别中推荐的范围。
天津母婴队列。
18-45 岁的单胎孕妇。
共纳入 69859 名孕妇。不良结局（包括死产、早产、妊娠高血压疾病、妊娠期糖尿病、胎儿大小与胎龄不符）与孕中期末 GWG 显著相关。风险评分与低体重、正常体重和超重组的 GWG 呈非线性相关。低体重组孕中期末 GWG 不应<7kg。对于大多数正常体重的女性，GWG 约为 8kg 是最佳的。超重的孕妇 GWG 不应超过 9kg。我们建议超重和肥胖的女性在孕早期和孕中期保持 GWG 的正增长（>0kg）。
根据综合母婴不良结局，我们建议孕中期末最佳 GWG。本研究可能为体重管理提供重要参考。
