Relationship between gestational weight gain and pregnancy outcomes in Songjiang District, Shanghai / 上海交通大学学报（医学版）

ABSTRACT

Objective • To understand the status of gestational weight gain (GWG) during pregnancy among women in Songjiang District, Shanghai, and to explore the relationship between GWG and birth outcomes. Methods • 4 884 cases were collected in Maternal and Child Health Hospital of Songjiang District, Shanghai from July to December 2016. According to the range of GWG formulated by the Institute of Medicine (IOM) in 2009, the subjects were divided into the insufficient GWG group, the normal GWG group, and the excessive GWG group. The relationship between GWG and the birth outcome of the newborn, mainly including the neonatal weight, the birth gestational week, the neonatal score, and the bad birth outcome such as premature delivery, small-for-gestational age (SGA), large-for-gestational age (LGA), and macrosomia were analyzed. Results • 25.7% of pregnant women gained underweight during pregnancy. 33.3% of pregnant women gained overweight during pregnancy. The GWG was positively correlated with birth weight (β=24.17, 95% CI 21.90-26.45, P=0.000). GWG was a protective factor for SGA (OR=0.89, 95% CI 0.87-0.91, P=0.000). GWG was a risk factor for LGA (OR=1.12, 95% CI 1.09-1.14, P=0.000) and macrosomia (OR=1.14, 95% CI 1.11-1.16, P=0.000). The GWG was positively associated with gestational age (β=0.03, 95% CI 0.03-0.04, P=0.000). The incidence of the premature delivery decreased with the increasing of GWG (OR=0.91, 95% CI 0.88-0.95, P=0.000). Women with insufficient GWG exhibited increased risks of SGA infants (OR=1.54, 95% CI 1.22-1.94, P=0.000) and premature delivery (OR=1.53, 95% CI 1.03-2.26, P=0.034), whereas women with excessive GWG exhibited increased risk of LGA (OR=2.20, 95% CI 1.71-2.84, P=0.000) and macrosomia (OR=2.41, 95% CI 1.86-3.11, P=0.000), when compared with women who had normal GWG. Conclusion • It is of great significance to maintain proper GWG and to improve the outcome of birth. Attention should be paid to the management of weight during pregnancy.