Associations of prepregnancy weight change with fetal growth and adverse birth outcomes: a prospective cohort study in China.

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition Pub Date : 2025-06-11 DOI:10.1016/j.ajcnut.2025.06.007

Yuwei Lai, Xianli Li, Yuxiang Wang, Ping Wu, Tingting Geng, Yi-Xiang Ye, Jiaying Yuan, Yayi Hu, Gang Liu, An Pan, Xiong-Fei Pan

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引用次数: 0

Abstract

Background: Evidence regarding prepregnancy weight change (from age 18 to conception) and fetal outcomes remains limited in Asian populations.

Objectives: To explore the associations of prepregnancy weight change with fetal growth and adverse birth outcomes, and the joint effects between prepregnancy weight change and gestational weight gain (GWG) among Chinese women.

Methods: We included 6330 pregnant women from the Tongji-Huaxi-Shuangliu Birth Cohort. Prepregnancy weight change was defined as the difference between the recalled weight at age 18 and recalled weight just before pregnancy. Ultrasound-assessed fetal growth parameters at 3 gestational intervals (≤24, 25-32, and 33-42 wk) were standardized to Z-scores. Adverse birth outcomes were obtained from medical records. Associations were assessed using linear mixed and logistic regression models.

Results: Compared with women with low prepregnancy weight gain (0.0-4.9 kg), those with high prepregnancy weight gain (≥10.0 kg) had significantly higher Z-scores for all fetal growth parameters. Positive associations with femur length and estimated fetal weight were observed across all gestational periods, whereas head circumference, abdominal circumference, and biparietal diameter showed significant associations only after 25 wk. Prepregnancy weight gain exhibited a dose-response association with higher risks of macrosomia and large for gestational age (LGA) (all P < 0.001). Conversely, prepregnancy weight loss was linked to a higher risk of small for gestational age (SGA) in female newborns. Furthermore, women with high prepregnancy weight gain and excessive GWG had the highest risks of macrosomia (odds ratio: 5.55; 95% confidence interval: 3.34, 9.22) and LGA (3.19; 2.37, 4.28).

Conclusions: Excessive prepregnancy weight gain was associated with accelerated fetal growth and increased macrosomia and LGA risks, whereas prepregnancy weight loss showed a sex-specific impact on SGA. The combination of high prepregnancy weight gain and excessive GWG was associated with the highest risks of macrosomia and LGA.

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孕前体重变化与胎儿生长和不良出生结局的关系：中国的一项前瞻性队列研究。

背景：在亚洲人群中，关于孕前体重变化（从18岁到受孕）和胎儿结局的证据仍然有限。目的：探讨中国妇女孕前体重变化与胎儿生长和不良出生结局的关系，以及孕前体重变化与妊娠体重增加（GWG）的联合作用。方法：纳入同济-华西-双流出生队列孕妇6330例。孕前体重变化被定义为18岁时的体重与怀孕前的体重之间的差异。超声评估三个妊娠间隔（≤24,25 -32和33-42周）的胎儿生长参数标准化为Z评分。从医疗记录中获得不良出生结果。使用线性混合和逻辑回归模型评估相关性。结果：与低孕前增重组（0 ~ 4.9 kg）相比，高孕前增重组（≥10.0 kg）胎儿生长参数Z评分显著高于低孕前增重组。在所有妊娠期内，股骨长度和胎儿体重都与胎儿体重呈正相关，而头围、腹围和双顶直径只有在25周后才显示出显著的相关性。妊娠前体重增加与较大儿和大胎龄儿（LGA）风险呈剂量反应相关性（均P < 0.001）。相反，怀孕前体重减轻与女性新生儿较高的小胎龄（SGA）风险有关。此外，孕前体重增加高和GWG过高的妇女发生巨大儿的风险最高(优势比[OR]: 5.55；95%置信区间[CI]: 3.34, 9.22)和LGA (OR: 3.19；95% ci: 2.37, 4.28)。结论：孕前体重过度增加与胎儿生长加速、巨大儿和LGA风险增加有关，而孕前体重减轻对SGA有性别特异性影响。高孕前体重增加和高GWG的组合与巨大儿和LGA的最高风险相关。

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来源期刊

American Journal of Clinical Nutrition 医学-营养学

CiteScore

12.40

自引率

4.20%

发文量

332

审稿时长

38 days

期刊介绍： American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism. Purpose: The purpose of AJCN is to: Publish original research studies relevant to human and clinical nutrition. Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits. Encourage public health and epidemiologic studies relevant to human nutrition. Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches. Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles. Peer Review Process: All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.