Department of Healthcare, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, P.R. China.
Department of women's health care, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, P.R. China.
J Matern Fetal Neonatal Med. 2024 Dec;37(1):2316732. doi: 10.1080/14767058.2024.2316732. Epub 2024 Feb 15.
To investigate the associations of body mass index (BMI) change and large for gestational age (LGA) among prepregnancy normal-weight women with and without gestational diabetes mellitus (GDM).
The retrospective study including 9515 normal-weight pregnant women (1331 women with GDM and 8184 without GDM) was conducted in Fujian Maternity and Child Health Hospital in 2020. The BMI change was calculated as gestational weight gain in kilograms by maternal height in meters. The binary logistic regression, stratified analyses, restricted cubic spline models and additive interaction analysis were adopted to reveal the relationship between BMI change and LGA.
Pregnant women with GDM had a lower level of BMI change but a higher incidence of LGA compared with those without GDM. After adjustment for covariates variables, we found that the risk of LGA was associated with the highest quartile of BMI change (OR = 1.89, 95%CI:1.27-2.8 for GDM and OR = 1.48,95%CI:1.27-1.75 for non-GDM). There were significant linear relationships of BMI change and LGA with the inflection point of 5.096 and 5.401 kg/m in GDM and non-GDM groups. Significant additive interaction was observed between parity and BMI change level concerning LGA. A significant difference in BMI change and gestational weight gain (GWG) for LGA prediction was detected.
Higher BMI changes were significantly associated with a higher risk of LGA in pregnant women with or without GDM in a linear dose-response relationship, with the threshold around 5.096 and 5.401 kg/m, respectively. These suggested that BMI changes may be a useful predictor for the incidence of LGA in singleton pregnant women.
探讨孕前体重正常的妊娠期糖尿病（GDM）妇女和非 GDM 妇女中，体重指数（BMI）变化与巨大儿（LGA）的相关性。
本回顾性研究纳入了 2020 年在福建省妇幼保健院就诊的 9515 例孕前体重正常的孕妇（GDM 组 1331 例，非 GDM 组 8184 例）。BMI 变化用体重（kg）除以身高（m）的平方来计算。采用二项逻辑回归、分层分析、限制性三次样条模型和附加交互作用分析来揭示 BMI 变化与 LGA 之间的关系。
与非 GDM 组相比，GDM 组孕妇的 BMI 变化水平较低，但 LGA 的发生率较高。在调整了协变量变量后，我们发现 LGA 的风险与 BMI 变化最高四分位（GDM 组 OR=1.89，95%CI：1.27-2.8；非 GDM 组 OR=1.48，95%CI：1.27-1.75）有关。BMI 变化与 LGA 之间存在显著的线性关系，在 GDM 和非 GDM 组中的拐点分别为 5.096 和 5.401 kg/m。在 GDM 组中，BMI 变化水平与产次之间存在显著的附加交互作用，与 LGA 有关。在预测 LGA 方面，BMI 变化和 GWG 存在显著差异。
在患有或不患有 GDM 的孕妇中，BMI 变化与 LGA 风险呈线性剂量反应关系，当 BMI 变化分别达到 5.096 和 5.401 kg/m 时，LGA 风险显著增加。这表明 BMI 变化可能是预测单胎孕妇 LGA 发生率的一个有用指标。
