Advertisement

Maternal and Child Health Journal

, Volume 18, Issue 1, pp 10–15 | Cite as

Overweight, Gestational Weight Gain and Elevated Fasting Plasma Glucose and Their Association with Macrosomia in Chinese Pregnant Women

  • Peng Shi
  • Wenhong Yang
  • Qian Yu
  • Qian Zhao
  • Chunying Li
  • Xiaoling Ma
  • Lihua Jin
  • Xia Han
  • Yi Zhang
  • Weili YanEmail author
Brief Report

Abstract

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.

Keywords

Overweight Gestational weight gain Fasting plasma glucose Macrosomia Chinese 

Notes

Acknowledgments

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.

References

  1. 1.
    Catalano, P. M., McIntyre, H. D., Cruickshank, J. K., McCance, D. R., Dyer, A. R., Metzger, B. E., et al. (2012). The hyperglycemia and adverse pregnancy outcome study: Associations of GDM and obesity with pregnancy outcomes. Diabetes Care, 35, 780–786.CrossRefGoogle Scholar
  2. 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
  3. 3.
    Metzger, B. E., Lowe, L. P., Dyer, A. R., Trimble, E. R., Chaovarindr, U., Coustan, D. R., et al. (2008). Hyperglycemia and adverse pregnancy outcomes. New England Journal of Medicine, 358, 1991–2002.CrossRefGoogle Scholar
  4. 4.
    Metzger, B. E., Gabbe, S. G., Persson, B., Buchanan, T. A., Catalano, P. A., Damm, P., et al. (2010). International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care, 33, 676–682.CrossRefGoogle Scholar
  5. 5.
    Yang, W., Lu, J., Weng, J., Jia, W., Ji, L., Xiao, J., et al. (2010). Prevalence of diabetes among men and women in China. New England Journal of Medicine, 362, 1090–1101.CrossRefGoogle Scholar
  6. 6.
    Chen, C. M. (2008). Overview of obesity in Mainland China. Obesity Reviews, 9(Suppl 1), 14–21.CrossRefGoogle Scholar
  7. 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. 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
  9. 9.
    Liu, Y., Dai, W., Dai, X., & Li, Z. (2012). Prepregnancy body mass index and gestational weight gain with the outcome of pregnancy: A 13-year study of 292,568 cases in China. Archives of Gynecology and Obstetrics, 286, 905–911.CrossRefGoogle Scholar
  10. 10.
    Kunshan China(the official government website of Kunshan City). http://en.ks.gov.cn/. Accessed 1 Feb 2013.
  11. 11.
    Callaway, L. K., Prins, J. B., Chang, A. M., & McIntyre, H. D. (2006). The prevalence and impact of overweight and obesity in an Australian obstetric population. Medical Journal of Australia, 184, 56–59.PubMedGoogle Scholar
  12. 12.
    Lu, G. C., Rouse, D. J., DuBard, M., Cliver, S., Kimberlin, D., & Hauth, J. C. (2001). The effect of the increasing prevalence of maternal obesity on perinatal morbidity. American Journal of Obstetrics and Gynecology, 185, 845–849.CrossRefGoogle Scholar
  13. 13.
    Ehrenberg, H. M., Dierker, L., Milluzzi, C., & Mercer, B. M. (2002). Prevalence of maternal obesity in an urban center. American Journal of Obstetrics and Gynecology, 187, 1189–1193.CrossRefGoogle Scholar
  14. 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. 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. 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
  17. 17.
    Kim, C. (2010). Gestational diabetes: Risks, management, and treatment options. International Journal of Women’s Health, 2, 339–351.CrossRefGoogle Scholar
  18. 18.
    Catalano, P. M. (2007). Management of obesity in pregnancy. Obstetrics and Gynecology, 109, 419–433.CrossRefGoogle Scholar
  19. 19.
    National Diabetes Information Clearinghouse. National Diabetes Statistics. (2011). http://diabetes.niddk.nih.gov/dm/pubs/statistics/index.aspx#Gestational. Accessed 1 Feb 2013.
  20. 20.
    Ma, R. C., & Chan, J. C. (2009). Pregnancy and diabetes scenario around the world: China. International Journal of Gynaecology and Obstetrics, 104(Suppl 1), S42–S45.CrossRefGoogle Scholar
  21. 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.
  22. 22.
    Chen, Z., Du, J., Shao, L., Zheng, L., Wu, M., Ai, M., et al. (2010). Prepregnancy body mass index, gestational weight gain, and pregnancy outcomes in China. International Journal of Gynaecology and Obstetrics, 109, 41–44.CrossRefGoogle Scholar
  23. 23.
    WHO expert consultation. (2004). Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet, 363, 157–163.CrossRefGoogle Scholar
  24. 24.
    Wong, W., Tang, N. L., Lau, T. K., & Wong, T. W. (2000). A new recommendation for maternal weight gain in Chinese women. Journal of the American Dietetic Association, 100, 791–796.CrossRefGoogle Scholar
  25. 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
  26. 26.
    Yang, X., Hsu-Hage, B., Zhang, H., Zhang, C., & Zhang, Y. (2002). Women with impaired glucose tolerance during pregnancy have significantly poor pregnancy outcomes. Diabetes Care, 25, 1619–1624.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Peng Shi
    • 1
  • Wenhong Yang
    • 2
  • Qian Yu
    • 2
  • Qian Zhao
    • 1
  • Chunying Li
    • 2
  • Xiaoling Ma
    • 2
  • Lihua Jin
    • 2
  • Xia Han
    • 2
  • Yi Zhang
    • 1
  • Weili Yan
    • 1
    Email author
  1. 1.Department of Clinical EpidemiologyChildren’s Hospital of Fudan UniversityShanghaiChina
  2. 2.Kunshan Maternity and Child Care CenterKunshanChina

Personalised recommendations