Effect of weight gain rate in the second and third trimesters of pregnancy on maternal and neonatal health: A cross-sectional study

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-07-09 DOI:10.1016/j.clnesp.2025.07.004

Wen Hua , Sha Lu , Lijun Zhang , Fangfang Chen , Jiahui Xu , Danxiao Wang , Nisile Kakongoma , Wensheng Hu

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引用次数: 0

Abstract

Objective

We aimed to investigate the association between gestational weight gain rate (GWGR) in the second and third trimesters (ISTT) and both pregnancy complications and perinatal outcomes.

Methods

This was a cross-sectional study of data from the 2664 pregnant women between March 2018 and December 2018. Pregnant women were grouped by different GWGRs ISTT according to the latest recommendation for maternal weight gain in 2021 and they were classified as below (insufficient GWGR), within (normal GWGR) and above (excessive GWGR) the standard. According to the level of pre-pregnancy body mass index (BMI), these pregnancies were further divided into low BMI, normal BMI and high BMI subgroups. Pregnancy complications and outcomes in each group were analyzed. One-way ANOVA test, Chi-squared test, Fisher's exact test and Logistic regression were used for statistical analysis.

Results

Logistic regression analysis demonstrated that excessive GWGR was associated with an increased risk of hypertensive disorders of pregnancy (HDP) (AOR = 2.197, 95%CI: 1.561–5.274), hyperlipidemia (AOR = 1.567, 95%CI: 1.284–1.871), macrosomia (AOR = 1.788, 95%CI: 1.183–2.702), LGA (AOR = 1.661, 95%CI: 1.327–2.088), preterm neonates (AOR = 2.416, 95%CI: 1.429–3.519) and caesarean section (AOR = 1.434, 95%CI: 1.191–1.727), while a decreased risk of gestational diabetes mellitus (GDM) (AOR = 0.436, 95%CI: 0.332–0.572); and insufficient GWGR was associated with a decreased risk of hyperlipidemia (AOR = 0.578, 95%CI: 0.351–0.951) and gestational hepatic dysfunction (AOR = 0.348, 95%CI: 0.182–0.811), while an increased risk of GDM (AOR = 2.212, 95%CI: 1.652–2.962). In the low BMI subgroup, insufficient GWGR were associated with a decreased risk of GDM respectively (AOR = 0.295, 95%CI: 0.139–0.629; AOR = 0.471, 95%CI: 0.234–0.948). In the high BMI subgroup, insufficient GWGR was associated with an increased risk of GDM (AOR = 3.593, 95%CI: 1.586–8.140), hyperlipidemia (AOR = 4.929, 95%CI: 1.315–18.479) and preterm neonates (AOR = 3.083, 95%CI: 1.050–9.155), and excessive GWGR was associated with an increased risk of GDM (AOR = 2.819, 95%CI: 1.346–3.208), hyperlipidemia (AOR = 2.029, 95%CI: 1.168–5.365), macrosomia (AOR = 3.008, 95%CI: 1.003–9.020), LGA (AOR = 1.459, 95%CI: 1.046–2.036) and caesarean section (AOR = 1.552, 95%CI: 1.142–2.110).

Conclusions

In this study, we found that 65.4 % of women did not achieve optimal GWGR. Insufficient GWGR ISTT was associated with decreased risk of pregnancy complications, in particular with hyperlipidemia. Excessive GWGR ISTT was associated with severe adverse birth outcomes, especially among women with high pre-pregnancy BMI. Although associations between GWGR and perinatal outcomes were observed, subsequent longitudinal studies are required to establish causal relationships.

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妊娠中期和晚期体重增加率对孕产妇和新生儿健康的影响：一项横断面研究

目的：探讨妊娠中期和晚期体重增加率（GWGR）与妊娠并发症和围产期结局的关系。方法：这是一项对2018年3月至2018年12月期间2664名孕妇数据的横断面研究。根据2021年最新的孕妇增重建议，根据不同的GWGR ISTT对孕妇进行分组，并将其分为GWGR不足（低于标准）、GWGR正常（低于标准）和GWGR过高（高于标准）。根据孕前体重指数（BMI）水平，将这些孕妇进一步分为低BMI、正常BMI和高BMI亚组。分析各组妊娠并发症及结局。采用单因素方差分析、卡方检验、Fisher精确检验和Logistic回归进行统计分析。结果：Logistic回归分析显示，GWGR过高与妊娠期高血压疾病（HDP）（AOR = 2.197, 95%CI: 1.561 ~ 5.274）、高血糖（AOR = 1.567, 95%CI: 1.284 ~ 1.871）、巨大儿（AOR = 1.788, 95%CI: 1.183 ~ 2.702）、LGA （AOR = 1.661, 95%CI: 1.327 ~ 2.088）、早产儿（AOR = 2.416, 95%CI: 1.429 ~ 3.519）、剖宫产(AOR = 1.434, 95%CI：1.191 ~ 1.727)，妊娠期糖尿病（GDM）风险降低（AOR = 0.436, 95%CI: 0.332 ~ 0.572）；GWGR不足与高脂血症（AOR = 0.578, 95%CI: 0.351-0.951）和妊娠期肝功能障碍（AOR = 0.348, 95%CI: 0.182-0.811）的风险降低相关，而GDM （AOR = 2.212, 95%CI: 1.652-2.962）的风险增加相关。在低BMI亚组中，GWGR不足分别与GDM风险降低相关(AOR = 0.295, 95%CI: 0.139-0.629；Aor = 0.471, 95%ci: 0.234 ~ 0.948)。在高BMI亚组中，GWGR不足与GDM （AOR = 3.593, 95%CI: 1.586-8.140）、高脂血症（AOR = 4.929, 95%CI: 1.315-18.479）和早产（AOR = 3.083, 95%CI: 1.050-9.155）的风险增加相关，GWGR过高与GDM （AOR = 2.819, 95%CI: 1.346-3.208）、高脂血症（AOR =2.029, 95%CI: 1.158 -5.365）、巨大儿（AOR = 3.008, 95%CI: 1.003-9.020）、LGA （AOR = 1.459, 95%CI: 1.003-9.020）的风险增加相关。1.046 ~ 2.036)和剖宫产（AOR = 1.552, 95%CI: 1.142 ~ 2.110）。结论：在本研究中，我们发现65.4%的女性没有达到最佳GWGR。GWGR ISTT不足与妊娠并发症风险降低有关，特别是高脂血症。过量的GWGR ISTT与严重的不良分娩结局有关，特别是在孕前BMI高的妇女中。虽然观察到GWGR与围产期结局之间存在关联，但需要后续的纵向研究来建立因果关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.