Yuwei Lai, Xianli Li, Yuxiang Wang, Ping Wu, Tingting Geng, Yi-Xiang Ye, Jiaying Yuan, Yayi Hu, Gang Liu, An Pan, Xiong-Fei Pan
{"title":"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。","authors":"Yuwei Lai, Xianli Li, Yuxiang Wang, Ping Wu, Tingting Geng, Yi-Xiang Ye, Jiaying Yuan, Yayi Hu, Gang Liu, An Pan, Xiong-Fei Pan","doi":"10.1016/j.ajcnut.2025.06.007","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Evidence regarding prepregnancy weight change (from age 18 to conception) and fetal outcomes remains limited in Asian populations.</p><p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5000,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Associations of prepregnancy weight change with fetal growth and adverse birth outcomes: a prospective cohort study in China.\",\"authors\":\"Yuwei Lai, Xianli Li, Yuxiang Wang, Ping Wu, Tingting Geng, Yi-Xiang Ye, Jiaying Yuan, Yayi Hu, Gang Liu, An Pan, Xiong-Fei Pan\",\"doi\":\"10.1016/j.ajcnut.2025.06.007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Evidence regarding prepregnancy weight change (from age 18 to conception) and fetal outcomes remains limited in Asian populations.</p><p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":50813,\"journal\":{\"name\":\"American Journal of Clinical Nutrition\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.5000,\"publicationDate\":\"2025-06-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Clinical Nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ajcnut.2025.06.007\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Clinical Nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ajcnut.2025.06.007","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
Associations of prepregnancy weight change with fetal growth and adverse birth outcomes: a prospective cohort study in China.
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.
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.
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