The Study Of The Recommended Range Of Weight Gain During The Second And Third Trimesters In Women With Gestational Diabetes Mellitus

BackgroundGDM and inappropriate GWG are closely associated with maternal and infant health in the short and long term.GDM and GWG have cumulative effects on adverse pregnancy outcomes.The appropriate weight gain range for GDM women during the second and third trimesters is still lacking.Therefore,it is urgent to explore the appropriate weekly weight gain range for women with GDM during the second and third trimesters.ObjectivesThe aim of this study was to understand the correlation between weight gain in the second and third trimesters pregnancy and adverse pregnancy outcomes in Chinese women with GDM,and propose the appropriate recommended range of weight gain in the second and third trimester of pregnancy in Chinese women with GDM.MethodsA retrospective cohort study,strictly following the inclusion criteria,was conducted to include singlet pregnant women diagnosed with GDM who received 75g OGTT at 24 to 28 weeks of gestation from 8 hospitals in China from 2011 to 2021,and clinical data of the subjects were collected.IR method,ROC method and comprehensive evaluation method were used to calculate the recommended range of weight gain in women with GDM during the second and third trimester of pregnancy.The obtained range was verified by Logistic regression,and the significance test level was two-sided α=0.05.Results1.General characteristics of GDM womenA total of 11168 women with GDM were included.Prepregnancy BMI of normal weight accounted for the most(61.20%),followed by overweight(24.85%),low weight(7.25%)and obesity(6.70%).The preterm birth,SGA,LGA,LBW and macrobaby accounted for 5.10%,5.58%,11.98%,2.84%and 6.84%,respectively.2.The recommended range of weight gain in GDM women during the second and third trimesters of pregnancya)IR method(P25 to P75):The recommended range was 0.26 to 0.54 kg/week for the low body weight group;The normal weight group was 0.21 to 0.52 kg/week.The overweight group was from 0.15 to 0.50 kg/week.The obesity group was 0.13 to 0.50 kg/week.b)ROC method:The upper limits were 0.65 kg/week for the low body weight group,0.31 kg/week for the normal body weight group,0.22 kg/week for the overweight group,and 0.23 kg/week for the obese group.c)Comprehensive evaluation method:the recommended range was 0.46(0.37-0.56)kg/week for the low body weight group;The normal weight group was 0.37(0.26-0.48)kg/week;The overweight group was 0.26(0.19-0.32)kg/week;The obese group was 0.18(0.12-0.23)kg/week.ConclusionsThe recommended weight gain values of GDM women with different pre-pregnancy BMI obtained in this study are as follows:the low weight group was 0.46(0.37-0.56)kg/week,the normal weight group was 0.37(0.26-0.48)kg/week,the overweight group was 0.26(0.19～0.32)kg/week,and the obese group was 0.18(0.12～0.23)kg/week.