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Seeking the optimal gestational weight gain according to the pre-pregnancy body mass index: a cross-sectional study from Shanghai, China

European Journal of Clinical Nutrition (2024)Cite this article

Subjects

Abstract

Objectives

Maternal nutritional status is closely related to fetal intrauterine development and an abnormal birth weight increases various disease risks across life stages. To better guide pregnancy weight gain, we aimed to explore the optimal weight gain for pregnant women with different body mass indexes (BMIs).

Methods

This retrospective cohort study included 68,981 women with singleton live birth between January 2017 and October 2021 in maternity centres in Shanghai, China. The fluctuations of the incidence of small and large for gestational age (small for gestational age (SGA) and LGA, respectively) were recorded at different maternal pre-pregnancy BMI (p-BMI) and different gestational weight gain (GWG) groups to find the lowest point of abnormal fetal weight incidence. The optimal GWG was then determined using a linear regression equation.

Result

The lowest risk of LGA/SGA was associated with a maternal p-BMI of 19.46 kg/m2. For pregnant women with maternal p-BMI below 24 kg/m2, we confirmed an optimal GWG linear equation: opt GWG (kg) = −1.94 × p-BMI (kg/m²) + 51, which showed an excellent degree of fit. Women who were overweight and obese could not achieve the lowest risk of LGA/SGA despite controlling their GWG; hence, their BMI should be normalized before pregnancy.

Conclusion

By merely using the pre-pregnancy BMI, this study has established the optimal GWG equation, with the goal of achieving the appropriate fetal gestational age. It is a practical measure to ensure desirable pregnancy outcomes and meet the health economics requirements.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We acknowledge the contribution and support of the mothers and families.

Funding

This research has no funding to support.

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Author notes

  1. These authors contributed equally: Jing Gao, Min Li.

Authors and Affiliations

  1. International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No. 910 Hengshan Road, Shanghai, 200030, China

    Jing Gao, Min Li, Shang Gao & Weiwei Cheng

  2. Shanghai Key Laboratory of Embryo Original Disease, Shanghai, 200040, China

    Jing Gao, Min Li, Shang Gao & Weiwei Cheng

  3. Shanghai Municipal Key Clinical Specialty, Shanghai, 200030, China

    Jing Gao, Min Li, Shang Gao & Weiwei Cheng

  4. School of Public Health, Fudan University, Shanghai, 20030, China

    Fei Qin

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  1. Jing Gao
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  4. Fei Qin
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Contributions

Gao Jing and Li Min contributed to data collection and analysis and to writing and revising the manuscript. Gao Shang and Qin Fei contributed to data collection and data interpretation. Cheng WeiWei contributed to the critical revision of the manuscript.

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Correspondence to Fei Qin or Weiwei Cheng.

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The authors declare no competing interests.

Ethical approval

This study conformed to the principles of the Declaration of Helsinki. Considering the retrospective nature of the study, the Ethics Committee of the International Peace Maternity and Child Health Hospital waived the requirement for informed consent.

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Gao, J., Li, M., Gao, S. et al. Seeking the optimal gestational weight gain according to the pre-pregnancy body mass index: a cross-sectional study from Shanghai, China. Eur J Clin Nutr (2024). https://doi.org/10.1038/s41430-024-01503-y

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