| ObjectiveTo investigate the association of maternal pre-pregnancy body mass index(BMI) and gestational weight gain(GWG) with birth weight and offspring obesity. MethodsThe subjects came from the China-Anhui Birth Cohort Study( C-ABC), During October 2008 and October 2010, pregnant women who accept routine health care in four municipal medical and health care were enrolled voluntarily in Ma’anshan City, all of 5 084 pregnant women and 4 669 singleton live births were included. Between April 2014 and April 2015, there were 3 803 preschool children completed the seventh follow-up of cohort, and the follow-up rate was 81.5%. In addition, except for women of incomplete medical information, pathological or obesity, finally 3 797 children were included in this analysis. Based on the “maternal and infant health care record form” were filled in pregnancy of first, second and last trimester, the basic information of subjects were collected. The contents of the questionnaire included general demographic information(age, residence, economic income, education level, occupation, marital status), living habits, adverse pregnancy history, history of diseases, and so on. The medical information of pregnant women(such as height, weight, blood pressure, etc.) were excerpted by investigators from the health care manual of pregnant women, and the data of maternal weight and height in pre-pregnancy were filled by themselves. “The Health and behavior record of preschool children” were filed by the major guardian to collect the information of preschool children, and the physical examination were completed by professional maternal and child health personnel, such as height and weight. Criteria for gestational weight gain(GWG): a new revision of the American Institute of medical research(IOM) in 2009. Children whose BMI above 85 th percentiles for age- and gender- cut-off values of World Health Organization(WHO) reference were considered as overweight, and above 95 th percentiles for age- and gender- cut-off values were considered as obesity(pathological and secondary obesity were excluded). χ2 test was used to evaluate the related influencing factors of overweight and obesity. Univariate and binary regression model analysis was used to examine the associations of maternal pre-pregnancy body mass index(BMI) and gestational weight gain(GWG) with birth weight and childhood overweight and obesity. ResultsThe prevalence of underweight was 22.6%(n=858), normal weight was 70.3%(n=2 671), overweight and obesity were respectively, 6.2%(n=234) and 0.9%(n=34) of the 3 797 pregnant women. Those who obtained gestational weight gain data were 3 563 pregnant women, the prevalence of inadequate GWG was 12.4%(n=443), appropriate GWG was 25.9%(n=922), excessive GWG was 61.7%(n=2 198). Of the infants, the prevalence of low birth weight, macrosomia, small for gestational age and large for gestational age were respectively 1.6%(n=60), 11.3%(n=430), 8.3%(n=310) and 23.3%(n=864). The prevalence of overweight and obesity were 11.5%(n=437) and 10.8%(n=411) respectively in preschool children.After adjusting confounding factors, binary logistic regression analysis showed that pre-pregnancy overweight and obesity were risk factors for macrosomia(OR=2.60, 95%CI: 1.86–3.63) and large for gestational age(LGA)( OR=2.45, 95%CI:1.84–3.27), pre-pregnancy underweight(OR=1.56, 95%CI:1.19–2.05) was risk factor for small for gestational age(SGA); After adjusting confounding factors, binary logistic regression analysis showed that excessive GWG were risk factors for macrosomia(OR=2.21, 95%CI:1.65–2.99)and large for gestational age(LGA)(OR=1.58, 95%CI:1.29–1.93); After adjusting confounding factors, binary logistic regression analysis showed that both pre-pregnancy overweight and obesity(OR=1.92, 95%CI : 1.43–2.57) and excessive GWG(OR=1.47,95%CI:1.18–1.83) were risk factors for overweight and obesity. We also noticed compared to only pre-pregnancy higher BMI or excessive GWG, combination of them, adverse effects on childhood overweight and obesity were much higher, OR values were 2.79,(95% CI: 1.87–4.16).ConclusionBoth inappropriate pre-pregnancy BMI and GWG resulted the excessive growth of fetal weight and offspring overweight or obesity. Therefore, reproductive age women need to adjust pregnant weight to normal level, and the doctors need to strengthen the management of pregnant women nutrition. To high-risk pregnant women should be monitored and guidanced to make pregnant women weight to be reasonable growth during pregnancy in order to reduce the occurrence of adverse birth outcomes and health effects in early life. |
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