Interaction between Abnormal Prepregnancy Body Mass Index and Hyperlipidemia during Pregnancy on the Risk of Gestational Diabetes Mellitus / 中国医学科学院学报

Objective To explore the interaction between abnormal prepregnancy body mass index(pBMI)and high blood lipid level during pregnancy on the risk of gestational diabetes mellitus(GDM). Methods A total of 235 patients with GDM and no blood lipid-related diseases before pregnancy were selected from Hangzhou Women's Hospital during March 2017 to July 2018 as the GDM group.At a ratio of 1∶3,a total of 705 individual age-matched pregnant women with normal glucose metabolism during prenatal examination from the same hospital were selected as the control group.The generalized multifactor dimension reduction(GMDR)method was employed to characterize the possible interaction between pBMI-blood lipid and GDM.The cross-validation consistency,equilibrium test accuracy,and P value were calculated to evaluate the interaction of each model. Results GMDR model analysis showed that the second-order model including pBMI and gestational blood lipid level had the best performance(P=0.001),with the cross-validation consistency of 10/10 and the equilibrium test accuracy of 64.48%,suggesting that there was a potential interaction between pBMI and gestational high blood lipid level.After adjustment of confounding factors,the model demonstrated that overweight/obesity patients with high triglyceride(TG) level had the highest risk of developing GDM(OR=14.349,95%CI=6.449-31.924,P<0.001).Stratified analysis showed that overweight/obesity patients under high TG level group had a higher risk of developing GDM than normal weight individuals(OR=2.243,95%CI=1.173-4.290,P=0.015). Conclusions Abnormal pBMI and high blood lipid level during pregnancy are the risk factors of GDM and have an interaction between each other.Overweight/obese pregnant women with high TG levels are more likely to develop GDM.

Association between Maternal Weight Indicators and Iron Deficiency Anemia during Pregnancy: A Cohort Study / 中华医学杂志(英文版)

<p><b>Background</b>The effect of maternal weights on the risk of iron deficiency anemia (IDA) during pregnancy remains unclear. The study aimed to investigate the association between maternal weight indicators and IDA during pregnancy.</p><p><b>Methods</b>We conducted a cohort study to examine the association between maternal weight indicators, including prepregnancy body mass index and the rate of gestational weight gain (GWG), and the risk of IDA among Chinese pregnant women. Data about new-onset IDA at different trimesters from a national cross-sectional survey were collected; information regarding baseline variables and rate of GWG from women participating in the survey were retrospectively collected. Tested IDA and reported IDA were documented. Multilevel logistic regression to examine the association between maternal weight indicators and the risk of IDA after adjusting for potential confounders was conducted.</p><p><b>Results</b>This study enrolled 11,782 pregnant women from 24 hospitals from September 19, 2016, to November 20, 2016. Among those, 1515 (12.9%) IDA events were diagnosed through test (test IDA); 3915 (33.3%) were identified through test and patient reporting (composite IDA). After adjusting for confounders and cluster effect of hospitals, underweight pregnant women, compared with normal women, were associated with higher risk of test IDA (adjusted odds ratio [aOR]: 1.35, 95% confidence interval [CI]: 1.17-1.57 and composite IDA (aOR: 1.35, 95% CI: 1.21-1.51); on the contrary, overweight and obese women had lower risk of test IDA (aOR: 0.68, 95% CI: 0.54-0.86 overweight; aOR: 0.30, 95% CI: 0.13-0.69 obese) and composite IDA (aOR: 0.77, 95% CI: 0.67-0.90 overweight; aOR: 0.34, 95% CI: 0.21-0.55 obese). The higher rate of GWG was associated with higher risk of IDA (test aOR: 1.86 95% CI: 1.26-2.76; composite aOR: 1.54, 95% CI: 1.16-2.03).</p><p><b>Conclusions</b>Pregnant women who are underweight before pregnancy and who have faster GWG are more likely to develop IDA. Enforced weight control during pregnancy and use of iron supplements, particularly among underweight women, may be warranted.</p>

Relationship of prepregnancy body mass index and gestational weight gain with gestational diabetes and gestational hypertension / 中国医师进修杂志

Objective To study the relationship of prepregnancy body mass index (pBMI) and gestational weight gain (GWG) with gestational diabetes and gestational hypertension.Methods A total of 1240 women having performed routine prenatal care and maternal hospital delivery from February 2011 to February 2012 were enrolled,and pBMI,GWG,fasting plasma glucose and blood pressure at 24 to 28 weeks' gestation were recorded.Correlation analysis and Logistic regression analysis were used to study the associations.Results According to pBMI,light body weight group had 260 cases,normal body weight group had 917 cases,overweight group had 36 cases,obesity group had 27 cases.According to GWG,low gain group had 104 cases,normal gain group had 758 cases,middle gain group had 249 cases,high gain group had 129 cases.The correlation analysis showed that pBMI was negatively associated with GWG (r =-0.646,P ＜ 0.01).Compared with that of normal body weight group,the incidence of gestational diabetes was 11.11％ (4/36) in overweight group,OR =4.120,P ＜ 0.05 ; and 18.52％ (5/27) in obesity group,OR =7.492,P ＜ 0.05,and the incidence of gestational hypertension was 11.11％ (3/27),OR =6.243,P ＜ 0.05.Compared with that of normal gain group,the incidence of gestational diabetes was 15.38％ (16/104) in low gain group,OR =9.006,P ＜ 0.05,the incidence of gestational hypertension was 4.81％(5/104) in low gain group,OR =3.140,P ＜ 0.05,and the incidence of gestational hypertension was 4.65％(6/129) in high gain group,OR =3.033,P ＜ 0.05.No significant differences were observed in or between groups in fasting plasma glucose and blood pressure(P＞ 0.05).Conclusion It shows that pBMI is negatively associated with GWG,and high pBMI and low GWG is strongly related with gestational diabetes and gestational hypertension.

Effect of prepregnancy body mass index and gestational weight gain on obstetric and neonatal outcomes – A pilot study.

Objectives: The study was undertaken to explore the effects of prepregnancy body mass index (BMI) and excess weight gain on maternal and neonatal outcomes different maternal and neonatal outcomes. Methods: Obstetrics records of 496 singleton pregnant women delivered between 2007 and 2009 in IBN SINA Medical College Hospital were reviewed. On the basis of BMI on their first visit the patients were divided into 3 groups; Mat BMI Gr 1, normal (BMI 20–24.9 Kg/m2, n=366), Mat BMI Gr 2, overweight (BMI 25-29.9 Kg/m2, n=102), Mat BMI Gr 3, obese (BMI >30 Kg/m2, n=28). On the basis of gestational weight gain, the subject divided into 2 categories, Gets WtGain Gr A, gestational weight gain 8–15.9 Kg (n=315), Gest WtGain Gr B, gestational weight gain >16 Kg weight gain (n=181). Data were expressed as number (percentage). Proportion test was performed for comparison between two groups. P value <0.05 was taken as level of significance. Results: of the total 496 pregnant women 74.59% were between 19-34 years of age. Among all the women 64.11% had high school education of different grade. Of all the pregnancies 23.18% were nulliparous. Of the total 496 women 366 (79.79%) were normal weight, 102 (20.56%) overweight and 28 (5.64%) obese. Obese women group had significantly higher proportion of hypertensive cases compared to the normal weight (p<0.001) and overweight (p<0.01) group. Relatively higher proportion of macrosomia, birth trauma, shoulder dystocia and NICU admission among babies of obese women (p=ns). One hundred and eighty one (36.49%) of study subjects had gestational weight gain above the cut-off (>16 kg) value (p<0.001). Women with weight gain bout the cut-off level had relatively higher proportion of macrosomic babies (p=ns). Conclusions: The data reconfirmed that obesity is associated with hypertension. Significant proportion of women had weight gain more than cut-off value which needs to be addressed to ensure sound maternal and fetal wellbeing. However, a multicentre large scale study is warranted which may help the researchers to conclusively comment on the issue and thus plan future strategies for health care during pregnancy.

The Effect of Prepregnancy Body Mass Index and Weight Gain during Pregnancy on Infant Birth Weight

BACKGROUND: To examine the effect of weight gain during pregnancy and prepregnancy body mass index on infant birth weight in normal term pregnancy. METHODS: We analyzed the weight data from 501 women who were in healthy singleton term pregnancy in a general hospital in Seoul from Jan. 2001 to Jun. 2001. Among the 501 women, 209 women whose data were available to calculate weight gain in every trimester were chosen. To study the effect of maternal weight gain on infant birth weight, multiple regression analysis, controlled for selected covariables, was carried out on the entire sample and on each prepregnancy weight group. RESULTS: In all the subjects both prepregnancy body mass and weight gain significantly influenced birth weight. For the lower and normal BMI, each kilogram of maternal weight gain significantly increased birth weight. CONCLUSION: These observations supports the recent evidence for the association between maternal weight gain and birth weight, but only for woman whose prepregnancy BMI are lower and normal. High maternal prepregnancy BMI did not have any influence of weight gain on birth weight.