Deshpande Swapna, Kinnunen Tarja I, Mandlik Rubina, Khadilkar Anuradha, Otiv Suhas, Kulathinal Sangita
Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.
Growth and Paediatric Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Pune, India.
Matern Child Nutr. 2025 Jul;21(3):e13805. doi: 10.1111/mcn.13805. Epub 2025 Apr 28.
The influence of early pregnancy weight and gestational weight gain (GWG) on neonatal outcomes among Indian slum-dwellers remains understudied. A prospective cohort study summarised maternal weight trajectories using the longitudinal clustering technique and explored associations between these clusters and neonatal outcomes (low birthweight, small for gestational age [SGA] and preterm births) among 423 pregnant slum-dwelling women in Pune, India. Sociodemographic data, height and weight were measured at enrolment (< 12 weeks, 'early pregnancy'). Weight was additionally measured at 23 ± 1 ('mid-pregnancy'), 33 ± 1 ('late pregnancy'), 36-37 and 39-40 weeks. The mean age was 24.7 (95% CI, 23.3, 25.1) years and the mean BMI at enrolment was 22.3 (95% CI, 21.9, 22.7) kg/m. Underweight women had the highest GWG rates and total GWG, while obese women had the lowest. Four clusters were identified: Cluster 1 (n = 124, 97% normal and overweight women, GWG rate: 0.27 (95% CI, 0.24, 0.30) kg/week early-late pregnancy) was the reference group. Women in Cluster 2 (n = 146, 93% underweight and normal weight women, GWG rate: 0.31 (95% CI, 0.28, 0.34) kg/week early-late pregnancy) had a higher risk of having SGA and preterm newborns and women in Cluster 3 (n = 68, 100% overweight and obese women, GWG rate: 0.17, 95% CI, 0.12, 0.22 kg/week early-late pregnancy) had a higher risk of having preterm newborns than Cluster 1. The women in Cluster 4 (n = 85, 100% underweight and normal weight, mean early-late pregnancy GWG rate of 0.47, 95% CI, 0.44, 0.50 kg/week) showed no higher risk of adverse neonatal outcomes. This study highlights the need to monitor both pre-pregnancy BMI and weight throughout pregnancy to enhance the possibility of favourable neonatal outcomes.
印度贫民窟居民中，早期妊娠体重和孕期体重增加（GWG）对新生儿结局的影响仍未得到充分研究。一项前瞻性队列研究使用纵向聚类技术总结了母亲的体重轨迹，并探讨了这些聚类与印度浦那423名贫民窟孕妇的新生儿结局（低出生体重、小于胎龄儿[SGA]和早产）之间的关联。在入组时（<12周，“早孕”）测量社会人口学数据、身高和体重。在妊娠23±1周（“孕中期”）、33±1周（“孕晚期）、36 - 37周和39 - 40周时额外测量体重。平均年龄为24.7（95%CI，23.3，25.1）岁，入组时的平均BMI为22.3（95%CI，21.9，22.7）kg/m²。体重过轻的女性GWG率和总GWG最高，而肥胖女性最低。确定了四个聚类：聚类1（n = 124，97%为正常体重和超重女性，早孕至孕晚期GWG率：0.27（95%CI，0.24，0.30）kg/周）为参照组。聚类2（n = 146，93%为体重过轻和正常体重女性，早孕至孕晚期GWG率：0.31（95%CI，0.28，0.34）kg/周）的女性生出小于胎龄儿和早产新生儿的风险更高，聚类3（n = 68，100%为超重和肥胖女性，早孕至孕晚期GWG率：0.17，95%CI，0.12，0.22 kg/周）的女性生出早产新生儿的风险高于聚类1。聚类4（n = 85，100%为体重过轻和正常体重，早孕至孕晚期平均GWG率为0.47，95%CI，0.44，0.50 kg/周）的女性未显示出不良新生儿结局风险更高。本研究强调在整个孕期监测孕前BMI和体重以提高获得良好新生儿结局可能性的必要性。
