scholarly journals Association of gestational weight gain with cesarean section: a prospective birth cohort study in Southwest China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lujiao Huang ◽  
Ju Zhang ◽  
Hong Sun ◽  
Hongli Dong ◽  
Run Li ◽  
...  
Keyword(s):  
Weight Gain ◽  
Cesarean Section ◽  
Birth Cohort ◽  
Gestational Weight Gain ◽  
Southwest China ◽  
The Other ◽  
Public Health Issue ◽  
Birth Cohort Study ◽  
Gestational Weight ◽  
Prospective Birth Cohort

Abstract Background Cesarean section (CS) is a rising public health issue globally, and is particularly serious in China. Numerous studies have suggested that gestational weight gain (GWG) control may be an effective way to reduce the rate of CS. However, rare study has examined the association between GWG and CS among women in Southwest China. We proposed to examine their association based on a prospective birth cohort, and further to explore the optimal GWG range. Methods We retrieved data from a prospective birth cohort from Sichuan Provincial Hospital for Women and Children, Southwest China. Unconditional multivariable logistic regression was used to examine the association between GWG and CS by adjusting for potential confounders. In one analysis, we incorporated the GWG as a categorical variable according to the Institute of Medicine (IOM) recommendation, similar to the method used in the majority of previous studies. In the other analysis, we directly incorporated GWG as a continuous variable and natural cubic splines were used to characterize the potential nonlinear exposure-response relationship, aiming to identify the optimal GWG. We further stratified the above analysis by pre-pregnancy BMI and GDM, and then a heterogeneity test based on a multivariate meta-analysis was conducted to examine whether the stratum specific estimations agreed with each other. Results A total of 1363 participants were included. By adopting the IOM recommendation, the adjusted OR of CS was 0.63 (0.47, 0.84) for insufficient GWG and 1.42 (1.06, 1.88) for excessive GWG. After stratification by pre-pregnancy BMI, we found a higher risk of CS in associated with excessive GWG in the stratum of underweight compared with the other strata, which implied that pre-pregnancy BMI may be an effect modifier. By applying a flexible spline regression, the optimal GWG levels in terms of reducing the CS rate based on our data were more stringent than those of IOM recommendation, which were 9–12 kg for underweight women, < 19 kg for normal weight women and < 10 kg for overweight/obese women. Conclusions These results suggested that a more stringent recommendation should be applied in Southwest China, and that more attention should be given to underweight women.

scholarly journals Association of Gestational Weight Gain with Cesarean Section: A Prospective Birth Cohort Study in Southwest China

2020 ◽  
Author(s):  
Lujiao Huang ◽  
Ju Zhang ◽  
Hong Sun ◽  
Hongli Dong ◽  
Run Li ◽  
...  
Keyword(s):  
Weight Gain ◽  
Cesarean Section ◽  
Birth Cohort ◽  
Gestational Weight Gain ◽  
Southwest China ◽  
Public Health Issue ◽  
Birth Cohort Study ◽  
Institute Of Medicine ◽  
Gestational Weight ◽  
Prospective Birth Cohort

Abstract Background: Cesarean section (CS) is a rising public health issue globally, which is even worse in China. Numerous studies have suggested that gestational weight gain (GWG) control may be an effective way to reduce the rate of CS. However, rare study has examined the association between GWG and CS among women in Southwest China. We proposed to examine their association based on a prospective birth cohort, and further to explore the optimal GWG range.Methods: We retrieved data from a prospective birth cohort conducted in Sichuan Provincial Hospital for Women and Children, Southwest China. Unconditional multivariable logistic regression was used to examine the association between GWG and CS by adjusting for potential confounders. In one analysis, we incorporated the GWG as categorical variable according to the Institute of Medicine (IOM) recommendation, just as the majority of previous studies did. In the other analysis, we directly incorporated the GWG as continuous variable and natural cubic splines was used to characterize the potential nonlinear exposure-response relationship, aiming to identify the optimal GWG. We further stratified the above analysis by pre-pregnancy BMI and GDM, and then a heterogeneity test based on multivariate meta-analysis was conducted to examine whether the stratum specific estimation agreed with each other.Results: A total of 1363 participants were included. By adopting the IOM recommendation, the adjusted OR of CS was 0.63 (0.47, 0.84) for insufficient GWG and 1.42 (1.06, 1.88) for excessive GWG respectively. When stratified by pre-pregnancy BMI, we further found that BMI may be an effect modifier with a higher risk of excessive GWG seen in the underweight women. By applying a flexible spline regression, the optimal GWG in term of reducing CS based on our data were more stringent than that of IOM recommendation, which were 9-12 kg for underweight women, <20 kg for normal weight women and <10 kg for overweight/obese women. Conclusion: These results suggested a more stringent recommendation should be applied in Southwest China, and more attention should be given to those underweight women.

scholarly journals Association of Maternal Gestational Weight Gain With Left Ventricle Geometry and Function in Offspring at 4 Years of Age: A Prospective Birth Cohort Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Jian Wang ◽  
Bowen Du ◽  
Yujian Wu ◽  
Zhuoyan Li ◽  
Qian Chen ◽  
...  
Keyword(s):  
Weight Gain ◽  
Left Ventricle ◽  
Birth Cohort ◽  
Gestational Weight Gain ◽  
Interventricular Septum ◽  
Birth Cohort Study ◽  
Gestational Weight ◽  
Concentric Hypertrophy ◽  
Septal Thickness ◽  
And Function

Background: Maternal gestational weight gain (GWG) may be associated with cardiovascular diseases in the offspring from childhood to adulthood. We aimed to investigate the association between maternal GWG and the left ventricle (LV) geometry and function in the offspring, and explore the influence of the intrauterine environment on early childhood cardiac change.Methods: Data of 981 mother-offspring pairs from the Shanghai Birth Cohort was used. Maternal pre-pregnancy weight and height, weight in the first trimester (≤ 12 weeks), and before delivery were measured. The echocardiography, blood pressure, and anthropometry assessment were evaluated in the offspring at 4 years of age.Results: Interventricular septal thickness during diastole had a significantly positive correlation with total GWG [β = 0.009, (0.001, 0.017)]. In the second and third trimesters, LV mass index [β = 0.149, (0.015,0.282)], interventricular septal thickness in systole [β = 0.027, (0.011,0.043)], and in diastole [β = 0.014, (0.005,0.023)] were positively associated with GWG. The risks of eccentric [OR = 1.115, (1.232, 1.010)] and concentric hypertrophy [OR = 1.133, (1.259,1.018)] increased with the elevation of maternal GWG.Conclusions: This study suggested that the excessive maternal GWG was associated with the thickening of the interventricular septum in the offspring, especially during the second and third trimesters. Excessive GWG in the second and third trimesters was a risk factor for LV eccentric and concentric hypertrophy in the offspring.

scholarly journals Pre-pregnancy BMI, gestational weight gain and breast-feeding: a cohort study in China

2016 ◽  
Vol 20 (6) ◽  
pp. 1001-1008 ◽  
Author(s):  
Xing-Yong Tao ◽  
Kun Huang ◽  
Shuang-Qin Yan ◽  
A-Zhu Zuo ◽  
Rui-Wen Tao ◽  
...  
Keyword(s):  
Cohort Study ◽  
Weight Gain ◽  
Birth Cohort ◽  
Gestational Weight Gain ◽  
Breast Feeding ◽  
Early Termination ◽  
Birth Cohort Study ◽  
Exclusive Breast Feeding ◽  
Gestational Weight ◽  
Urban City

AbstractObjectiveThe purpose of the present study was to examine the influence of maternal pre-pregnancy BMI and gestational weight gain (GWG) on initiation and duration of infant breast-feeding in a prospective birth cohort study.DesignBreast-feeding information was collected at 1, 3, 6 and 12 months postpartum. The association of pre-pregnancy BMI and GWG with delayed lactogenesis II and termination of exclusive breast-feeding was assessed with logistic regression analysis. The risk of early termination of any breast-feeding during the first year postpartum was assessed with Cox proportional hazards models.SettingUrban city in China.SubjectsWomen with infants from the Ma’anshan Birth Cohort Study (n 3196).ResultsThe median duration of any breast-feeding in this cohort was 7·0 months. Pre-pregnancy obese women had higher risks of delayed lactogenesis II (risk ratio=1·89; 95 % CI 1·04, 3·43) and early termination of any breast-feeding (hazard ratio=1·38; 95 % CI 1·09, 1·75) adjusted for potential maternal and infant confounders, when compared with normal-weight women. No differences in breast-feeding initiation or duration of exclusive breast-feeding according to pre-pregnancy BMI were found. Moreover, GWG was not associated with any poor breast-feeding outcomes.ConclusionsThe present study indicated that pre-pregnancy obesity increases the risks of delayed lactogenesis II and early termination of any breast-feeding in Chinese women.

scholarly journals Maternal nutrition, inadequate gestational weight gain and birth weight: results from a prospective birth cohort

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Anke Diemert ◽  
Susanne Lezius ◽  
Mirja Pagenkemper ◽  
Gudula Hansen ◽  
Alina Drozdowska ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Birth Cohort ◽  
Gestational Weight Gain ◽  
Maternal Nutrition ◽  
Gestational Weight ◽  
Prospective Birth Cohort

scholarly journals Maternal Body Mass Index and Gestational Weight Gain and Their Association with Pregnancy Complications and Perinatal Conditions

2019 ◽  
Vol 16 (10) ◽  
pp. 1751 ◽  
Author(s):  
Martin Simko ◽  
Adrian Totka ◽  
Diana Vondrova ◽  
Martin Samohyl ◽  
Jana Jurkovicova ◽  
...  
Keyword(s):  
Weight Gain ◽  
Cesarean Section ◽  
Gestational Weight Gain ◽  
Gestational Hypertension ◽  
Overweight And Obesity ◽  
University Hospital ◽  
Maternal Body Mass Index ◽  
Gestational Weight ◽  
Gynecology And Obstetrics ◽  
The Impact

This study aimed to evaluate the impact of selected pregnancy pathologies statistically depending on overweight/obesity and excessive maternal weight gain during pregnancy on women who gave birth in the years 2013–2015 at the Second Department of Gynecology and Obstetrics at the University Hospital in Bratislava, Slovakia. In a retrospective study, we analyzed data gathered from the sample, which consisted of 7122 women. Our results suggest a statistically significant, higher risk for the groups of women with overweight and obesity and gestational hypertension (adjusted odds ratio (AOR) = 15.3; 95% CI 9.0−25.8 for obesity), preeclampsia (AOR = 3.4; 95% CI 1.9−6.0 for overweight and AOR = 13.2; 95% CI 7.7−22.5 for obesity), and gestational diabetes mellitus (AOR = 1.9; 95% CI 1.2−2.9 for overweight and AOR = 2.4; 95% CI 1.4−4.0 for obesity). A higher incidence of pregnancies terminated by cesarean section was observed in the group of obese women. Gestational weight gain above IOM (Institute of Medicine) recommendations was associated with a higher risk of pregnancy terminated by C-section (AOR = 1.2; 95% CI 1.0−1.3), gestational hypertension (AOR = 1.7; 95% CI 1.0−2.7), and infant macrosomia (AOR = 1.7; 95% CI 1.3−2.1). Overweight and obesity during pregnancy significantly contribute to the development of pregnancy pathologies and increased incidence of cesarean section. Systematic efforts to reduce weight before pregnancy through prepregnancy dietary counseling, regular physical activity, and healthy lifestyle should be the primary goal.

scholarly journals Excessive gestational weight gain in the first trimester is associated with risk of gestational diabetes mellitus: a prospective study from Southwest China

2019 ◽  
Vol 23 (3) ◽  
pp. 394-401 ◽  
Author(s):  
Xi Lan ◽  
Yi-qi Zhang ◽  
Hong-li Dong ◽  
Ju Zhang ◽  
Feng-ming Zhou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Southwest China ◽  
First Trimester ◽  
Normal Weight ◽  
Second Trimester ◽  
Obese Women ◽  
Gestational Weight ◽  
Iom Recommendations

AbstractObjective:To evaluate the effects of gestational weight gain (GWG) in the first trimester (GWG-F) and the rate of gestational weight gain in the second trimester (RGWG-S) on gestational diabetes mellitus (GDM), exploring the optimal GWG ranges for the avoidance of GDM in Chinese women.Design:A population-based prospective study was conducted. Gestational weight was measured regularly in every antenatal visit and assessed by the Institute of Medicine (IOM) criteria (2009). GDM was assessed with the 75-g, 2-h oral glucose tolerance test at 24–28 weeks of gestation. Multivariable logistic regression was performed to assess the effects of GWG-F and RGWG-S on GDM, stratified by pre-pregnancy BMI. In each BMI category, the GWG values corresponding to the lowest prevalence of GDM were defined as the optimal GWG range.Setting:Southwest China.Participants:Pregnant women (n 1910) in 2017.Results:After adjusting for confounders, GWG-F above IOM recommendations increased the risk of GDM (OR; 95 % CI) among underweight (2·500; 1·106, 5·655), normal-weight (1·396; 1·023, 1·906) and overweight/obese women (3·017; 1·118, 8·138) compared with women within IOM recommendations. No significant difference was observed between RGWG-S and GDM (P > 0·05) after adjusting for GWG-F based on the previous model. The optimal GWG-F ranges for the avoidance of GDM were 0·8–1·2, 0·8–1·2 and 0·35–0·70 kg for underweight, normal-weight and overweight/obese women, respectively.Conclusions:Excessive GWG in the first trimester, rather than the second trimester, is associated with increased risk of GDM regardless of pre-pregnancy BMI. Obstetricians should provide more pre-emptive guidance in achieving adequate GWG-F.

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