Overweight, Gestational Weight Gain and Elevated Fasting Plasma Glucose and Their Association with Macrosomia in Chinese Pregnant Women
- 575 Downloads
To provide a current estimation of overweight, gestational weight gain(GWG), elevated fasting plasma glucose (FPG) in pregnant women in Kunshan, China and investigate their association with macrosomia using recommendations of IOM and International Association of Diabetes and Pregnancy Study Groups. We conducted a population-based retrospective study and analyzed routine data from Kunshan Maternity and Child Care Surveillance System of 27,322 women with singleton full-term birth from 2006 to 2010. The prevalence of maternal overweight at early pregnancy according to WHO BMI categories (BMI: 25.0–29.9 kg/m2) or the cutoffs for Chinese (BMI:24.0–27.9 kg/m2), elevated FPG (≥5.1 mmol/L) were estimated. Proportions of women with GWG below, within and above 2009 IOM recommendations were used to evaluate the adequacy of GWG. The association between maternal overweight, GWG, elevated FPG and macrosomia was analyzed by multiple logistic regression. The prevalence of maternal overweight was 8.9 % according to WHO BMI categories and 11.9 % according to Chinese cutoffs. The rate of elevated FPG at first prenatal visit was 19.4 %. Overweight women gained, on average, 12.2 ± 5.3 or 13.0 ± 5.2 (kg) during gestation, 57.1 or 63.93 % of which had excessive weight gain above IOM recommendations (6.8–11.4 kg) according to WHO BMI categories or Chinese cutoffs, respectively. Maternal overweight, GWG and elevated FPG were positively and significantly associated with macrosomia after adjusting for maternal age and gestational weeks at delivery. Maternal overweight, excessive weight gain, elevated FPG are common in the Chinese population in Kunshan. These metabolic risk factors associated with macrosomia should be controlled under the recommendations for Chinese pregnant population.
KeywordsOverweight Gestational weight gain Fasting plasma glucose Macrosomia Chinese
This study is supported by grant National Science Foundation of China (Grant No. 81273168) and Reproductive & Developmental Research Project affiliated the 3rd Key Construction Program of the National “985” Project for Fudan University and Intramural funding of Children’s Hospital of Fudan University.
Conflict of interest
We declare no potential conflicts of interest relevant to this article.
- 2.Institute of Medicine. (2009). Weight gain during pregnancy: Reexamining the guidelines. 2010/07/30 ed. Washington DC, USA: The National Academies Press.Google Scholar
- 7.Yang, Y., & Yang, H. (2012). Investigation into the clinical suitability of Institute of Medicine 2009 guidelines regarding weight gain during pregnancy for women with full term singleton fetus in China. Chinese Journal of Obstetrics and Gynecology, 47, 646–650.Google Scholar
- 8.Wei, Y., Yang, H., & Gao, X. (2008). Investigation into the prevalence and suitable diagnostic criteria of gestational diabetes mellitus in China. Chinese Journal of Obstetrics and Gynecology, 43, 647–650.Google Scholar
- 10.Kunshan China(the official government website of Kunshan City). http://en.ks.gov.cn/. Accessed 1 Feb 2013.
- 14.Leung, T. Y., Leung, T. N., Sahota, D. S., Chan, O. K., Chan, L. W., Fung, T. Y., et al. (2008). Trends in maternal obesity and associated risks of adverse pregnancy outcomes in a population of Chinese women. BJOG: An International Journal of Obstetrics & Gynaecology, 115, 1529–1537.CrossRefGoogle Scholar
- 15.Obesity: preventing and managing the global epidemic. Report of a WHO consultation. (2000). World Health Organization Technical Report Series, 894, i–xii, 1–253.Google Scholar
- 16.Zhou, B. (2002). Cooperative meta-analysis group of the working group on obesity in China. Predictive value of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults—study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomedical and Environmental Sciences, 15, 83.PubMedGoogle Scholar
- 19.National Diabetes Information Clearinghouse. National Diabetes Statistics. (2011). http://diabetes.niddk.nih.gov/dm/pubs/statistics/index.aspx#Gestational. Accessed 1 Feb 2013.
- 21.Health survey for England—2010, trend tables:Adult trend tables. Department of Health. (2010). http://www.ic.nhs.uk/pubs/hse10trends. Accessed 1 Feb 2013.
- 25.Yu, D., Zhai, F., Zhao, L., Liu, A., Yu, W., Jia, F., et al. (2008). Incidence of fetal macrosomia and influencing factors in China in 2006. Chinese Journal of Child Health Care, 16, 3.Google Scholar