Background
Methods
Setting and participants
Recruitment
Measurements
BMI before pregnancy and GWG
Number of women with pregnancy outcomes that were adverse
Evaluation of different recommendation criteria for GWG
Definitions of adverse pregnancy outcomes
Statistical analysis
Results
Pre-pregnancy BMIs and GWGs
Frequency distribution of adverse outcomes
Total subjects per sublayer | PB n (%) | LBW n (%) | MAC n (%) | SGA n (%) | LGA n (%) | CS n (%) | GA n (%) | PROM n (%) | GDM n (%) | GH n (%) | |
---|---|---|---|---|---|---|---|---|---|---|---|
< 2 | 1 (0.2) | 1 (100) | 1 (100) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
≥ 2–4 | 1 (0.2) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
≥ 4–6 | 5 (1.2) | 1 (20.0) | 1 (20.0) | 0 (0) | 0 (0) | 0 (0) | 2 (40.0) | 1 (20.0) | 1 (20.0) | 1 (20) | 0 (0) |
≥ 6–8 | 13 (3.1) | 3 (23.1) | 3 (23.1) | 0 (0) | 2 (15.4) | 0 (0) | 5 (38.5) | 2 (15.4) | 3 (23.1) | 3 (23.1) | 0 (0) |
≥ 8–10 | 21 (5.0) | 3 (14.3) | 2 (9.5) | 0 (0) | 2 (9.5) | 0 (0) | 6 (28.6) | 0 (0) | 1 (4.8) | 1 (4.8) | 0 (0) |
≥ 10–12 | 50 (11.9) | 2 (4.0) | 1 (2.0) | 0 (0) | 4 (8.0) | 3 (6) | 10 (20.0) | 5 (10.0) | 5 (10.0) | 4 (8.0) | 0 (0) |
≥ 12–14 | 58 (13.8) | 3 (5.2) | 3 (5.2) | 1 (1.7) | 5 (8.6) | 4 (6.9) | 13 (22.4) | 4 (6.9) | 7 (12.1) | 6 (10.3) | 0 (0) |
≥ 14–16 | 82 (19.6) | 2 (2.4) | 5 (6.0) | 4 (4.8) | 9 (10.8) | 4 (4.8) | 24 (28.9) | 8 (9.6) | 9 (10.8) | 7 (8.4) | 1 (1.2) |
≥ 16–18 | 64 (15.3) | 6 (9.4) | 3 (4.7) | 0 (0) | 2 (3.1) | 1 (1.6) | 23 (35.9) | 13 (20.3) | 8 (12.5) | 4 (6.3) | 3 (4.7) |
≥ 18–20 | 42 (10.0) | 1 (2.4) | 0 (0) | 4 (9.5) | 1 (2.4) | 6 (14.3) | 15 (35.7) | 8 (19.0) | 3 (7.1) | 1 (2.4) | 1 (2.4) |
≥ 20–22 | 36 (8.6) | 0 (0) | 0 (0) | 3 (8.3) | 3 (8.3) | 3 (8.3) | 13 (36.1) | 4 (11.1) | 2 (5.6) | 2 (5.6) | 0 (0) |
≥ 22–24 | 20 (4.8) | 1 (5.0) | 2 (10.0) | 2 (10.0) | 4 (20.0) | 2 (10.0) | 6 (30.0) | 1 (5.0) | 4 (20.0) | 2 (10.0) | 0 (0) |
≥ 24–26 | 14 (3.3) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 5 (35.7) | 2 (14.3) | 3 (21.4) | 0 (0) | 0 (0) |
≥ 26–28 | 5 (1.2) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 2 (40.0) | 0 (0) | 0 (0) | 1 (20.0) | 0 (0) |
≥ 28 | 7 (1.7) | 0 (0) | 0 (0) | 2 (28.6) | 0 (0) | 2 (28.6) | 2 (28.6) | 2 (28.6) | 1 (14.3) | 1 (14.3) | 0 (0) |
Total | 420 | 23 (5.5) | 21 (5.0) | 16 (3.8) | 32 (7.6) | 25 (6.0) | 126 (30.0) | 50 (11.9) | 47 (11.2) | 33 (7.9) | 5 (1.2) |
Total subjects in sublayers | PB n (%) | LBW n (%) | MAC n (%) | SGA n (%) | LGA n (%) | CS n (%) | GA n (%) | PROM n (%) | GDM n (%) | GH n (%) | |
---|---|---|---|---|---|---|---|---|---|---|---|
< 2 | 14 (0.7) | 0 (0) | 2 (14.3) | 0 (0) | 5 (35.7) | 0 (0) | 7 (50.0) | 2 (14.3) | 2 (14.3) | 1 (7.1) | 0 (0) |
≥ 2–4 | 10 (0.5) | 1 (10.0) | 1 (10.0) | 1 (10.0) | 1 (10.0) | 2 (20.0) | 3 (30.0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
≥ 4–6 | 38 (1.8) | 5 (13.2) | 1 (2.6) | 0 (0) | 4 (10.5) | 3 (7.9) | 12 (31.6) | 4 (10.5) | 5 (13.2) | 10 (26.3) | 0 (0) |
≥ 6–8 | 55 (2.7) | 4 (7.3) | 4 (7.3) | 1 (1.8) | 7 (12.7) | 3 (5.5) | 25 (45.5) | 10 (18.2) | 3 (5.5) | 6 (10.9) | 1 (1.8) |
≥ 8–10 | 123 (6.0) | 7 (5.7) | 6 (4.9) | 6 (4.9) | 4 (3.3) | 8 (6.5) | 51 (41.5) | 18 (14.6) | 19 (15.4) | 25 (20.3) | 2 (1.6) |
≥ 10–12 | 316 (15.3) | 25 (7.9) | 17 (5.4) | 11 (3.5) | 23 (7.3) | 18 (5.7) | 101 (31.9) | 48 (15.1) | 48 (15.1) | 44 (13.9) | 6 (1.9) |
≥ 12–14 | 328 (15.9) | 12 (3.7) | 12 (3.7) | 15 (4.6) | 25 (7.6) | 26 (7.9) | 120 (36.6) | 46 (14.0) | 41 (12.5) | 30 (9.1) | 6 (1.8) |
≥ 14–16 | 424 (20.6) | 20 (4.7) | 15 (3.5) | 24 (5.7) | 23 (5.4) | 32 (7.5) | 188 (44.3) | 63 (14.9) | 43 (10.1) | 37 (8.7) | 7 (1.7) |
≥ 16–18 | 240 (11.7) | 4 (1.7) | 5 (2.1) | 14 (5.8) | 16 (6.7) | 22 (9.2) | 90 (37.5) | 44 (18.3) | 26 (10.8) | 19 (7.9) | 6 (2.5) |
≥ 18–20 | 191 (9.3) | 4 (2.1) | 6 (3.1) | 10 (5.2) | 9 (4.7) | 17 (8.9) | 75 (39.3) | 14 (7.3) | 15 (7.9) | 21 (11.0) | 5 (2.6) |
≥ 20–22 | 163 (7.9) | 3 (1.8) | 3 (1.8) | 13 (7.9) | 7 (4.3) | 23 (14.0) | 77 (47.0) | 25 (15.2) | 31 (18.9) | 11 (6.7) | 4 (2.4) |
≥ 22–24 | 68 (3.3) | 2 (2.9) | 1 (1.4) | 10 (14.5) | 1 (1.4) | 14 (20.3) | 40 (58.0) | 9 (13.0) | 6 (8.7) | 4 (5.8) | 2 (2.9) |
≥ 24–26 | 49 (2.4) | 1 (2.0) | 0 (0) | 8 (16.3) | 0 (0) | 10 (20.4) | 23 (46.9) | 10 (20.4) | 5 (10.2) | 1 (2.0) | 2 (4.1) |
≥ 26–28 | 19 (0.9) | 0 (0) | 0 (0) | 1 (5.3) | 1 (5.3) | 1 (5.3) | 7 (36.8) | 1 (5.3) | 4 (21.1) | 4 (21.1) | 0 (0) |
≥ 28 | 21 (1.0) | 0 (0) | 1 (4.8) | 2 (9.5) | 2 (9.5) | 2 (9.5) | 14 (66.7) | 2 (9.5) | 2 (9.5) | 1 (4.8) | 1 (4.8) |
Total | 2062 | 88 (4.3) | 74 (3.6) | 116 (5.6) | 128 (6.2) | 181 (8.8) | 833 (40.4) | 296 (14.4) | 250 (12.1) | 214 (10.4) | 42 (2.0) |
Total subjects in sublayers | PB n (%) | LBW n (%) | MAC n (%) | SGA n (%) | LGA n (%) | CS n (%) | GA n (%) | PROM n (%) | GDM n (%) | GH n (%) | |
---|---|---|---|---|---|---|---|---|---|---|---|
< 2 | 15 (2.7) | 0 (0) | 0 (0) | 2 (13.3) | 1 (6.7) | 2 (13.3) | 4 (26.7) | 1 (6.7) | 1 (6.7) | 2 (13.3) | 0 (0) |
≥ 2–4 | 5 (0.9) | 1 (20.0) | 1 (20.0) | 0 (0) | 0 (0) | 0 (0) | 4 (80.0) | 0 (0) | 1 (20.0) | 1 (20.0) | 1 (20.0) |
≥ 4–6 | 21 (3.8) | 5 (23.8) | 2 (9.5) | 1 (4.8) | 1 (4.8) | 1 (4.8) | 10 (47.6) | 3 (14.3) | 6 (28.6) | 8 (38.1) | 2 (9.5) |
≥ 6–8 | 33 (6.0) | 2 (6.1) | 2 (6.1) | 1 (3.0) | 4 (12.1) | 2 (6.1) | 17 (51.5) | 5 (15.2) | 4 (12.1) | 9 (27.3) | 0 (0) |
≥ 8–10 | 41 (7.4) | 1 (2.4) | 1 (2.4) | 1 (2.4) | 3 (7.1) | 3 (7.1) | 16 (38.1) | 5 (11.9) | 7 (16.7) | 8 (19.0) | 2 (4.8) |
≥ 10–12 | 94 (17.0) | 4 (4.3) | 1 (1.1) | 11 (11.7) | 1 (1.1) | 15 (16.0) | 53 (56.4) | 17 (18.1) | 9 (9.6) | 15 (16.0) | 2 (2.1) |
≥ 12–14 | 82 (14.8) | 5 (6.1) | 3 (3.7) | 14 (17.1) | 3 (3.7) | 17 (20.7) | 46 (56.1) | 12 (14.6) | 11 (13.4) | 10 (12.2) | 3 (3.7) |
≥ 14–16 | 92 (16.6) | 6 (6.5) | 1 (1.1) | 8 (8.6) | 3 (3.2) | 16 (17.2) | 54 (58.1) | 9 (9.7) | 18 (19.4) | 13 (14.0) | 3 (3.2) |
≥ 16–18 | 55 (9.9) | 3 (5.5) | 1 (1.8) | 8 (14.5) | 0 (0) | 11 (20.0) | 27 (49.1) | 9 (16.4) | 9 (16.4) | 8 (14.5) | 2 (3.6) |
≥ 18–20 | 40 (7.2) | 3 (7.5) | 1 (2.5) | 7 (17.5) | 1 (2.5) | 9 (22.5) | 21 (52.5) | 6 (15.0) | 7 (17.5) | 7 (17.5) | 2 (5.0) |
≥ 20–22 | 48 (8.7) | 3 (6.3) | 0 (0) | 9 (18.8) | 1 (2.1) | 15 (31.3) | 30 (62.5) | 10 (20.8) | 12 (25.0) | 12 (25.0) | 2 (4.2) |
≥ 22–24 | 13 (2.3) | 0 (0) | 1 (7.7) | 2 (15.4) | 2 (15.4) | 3 (23.1) | 8 (61.5) | 1 (7.7) | 1 (7.7) | 0 (0) | 1 (7.7) |
≥ 24–26 | 6 (1.1) | 0 (0) | 0 (0) | 2 (33.3) | 0 (0) | 2 (33.3) | 4 (66.7) | 2 (33.3) | 1 (16.7) | 1 (16.7) | 2 (33.3) |
≥ 26–28 | 3 (0.5) | 0 (0) | 0 (0) | 2 (66.7) | 0 (0) | 2 (66.7) | 2 (66.7) | 2 (66.7) | 0 (0) | 0 (0) | 0 (0) |
≥ 28 | 6 (1.1) | 0 (0) | 0 (0) | 1 (16.7) | 0 (0) | 2 (33.3) | 2 (33.3) | 0 (0) | 2 (33.3) | 0 (0) | 0 (0) |
Total | 556 | 33 (6.0) | 14 (2.5) | 69 (12.4) | 20 (3.6) | 100 (18.0) | 298 (53.6) | 82 (14.7) | 89 (16.0) | 94 (16.9) | 22 (4.0) |
Total Subjects in sub-layers | PB n (%) | LBW n (%) | MAC n (%) | SGA n (%) | LGA n (%) | CS n (%) | GA n (%) | PROM n (%) | GDM n (%) | GH n (%) | |
---|---|---|---|---|---|---|---|---|---|---|---|
< 2 | 9 (6.7) | 0 (0) | 0 (0) | 2 (22.2) | 0 (0) | 2 (22.2) | 4 (44.4) | 1 (11.1) | 0 (0) | 1 (11.1) | 0 (0) |
≥ 2–4 | 3 (2.2) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 1 (33.3) | 0 (0) | 0 (0) | 2 (66.7) | 0 (0) |
≥ 4–6 | 3 (2.2) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 1 (33.3) | 1 (33.3) | 0 (0) | 0 (0) | 0 (0) |
≥ 6–8 | 15 (11.2) | 1 (6.7) | 0 (0) | 3 (20) | 0 (0) | 4 (26.7) | 6 (40.0) | 1 (6.7) | 1 (6.7) | 4 (26.7) | 0 (0) |
≥ 8–10 | 15 (11.2) | 0 (0) | 0 (0) | 2 (13.3) | 1 (6.7) | 2 (13.3) | 7 (46.7) | 0 (0) | 1 (6.7) | 6 (40) | 1 (6.7) |
≥ 10–12 | 30 (22.4) | 2 (6.7) | 1 (3.3) | 2 (6.7) | 0 (0) | 5 (16.7) | 16 (53.3) | 5 (16.7) | 3 (10.0) | 3 (10) | 8 (26.7) |
≥ 12–14 | 15 (11.2) | 1 (6.7) | 1 (6.7) | 3 (20) | 1 (6.7) | 4 (26.7) | 7 (46.7) | 1 (6.7) | 3 (20.0) | 4 (26.7) | 4 (26.7) |
≥ 14–16 | 16 (11.9) | 1 (6.3) | 0 (0) | 4 (25.0) | 0 (0) | 5 (31.3) | 10 (62.5) | 3 (18.8) | 2 (12.5) | 7 (43.8) | 0 (0) |
≥ 16–18 | 11 (8.2) | 2 (18.2) | 1 (9.1) | 2 (18.2) | 0 (0) | 3 (27.3) | 8 (72.7) | 2 (18.2) | 1 (9.1) | 0 (0) | 1 (9.1) |
≥ 18–20 | 9 (6.7) | 0 (0) | 0 (0) | 2 (22.2) | 0 (0) | 1 (11.1) | 5 (55.6) | 1 (11.1) | 0 (0) | 3 (33.3) | 0 (0) |
≥ 20–22 | 3 (2.2) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 2 (66.7) | 0 (0) | 0 (0) | 1 (33.3) | 0 (0) |
≥ 22–24 | 2 (1.5) | 0 (0) | 0 (0) | 1 (50) | 0 (0) | 1 (50) | 2 (100) | 0 (0) | 0 (0) | 0 (0) | 1 (50.0) |
≥ 24–26 | 2 (1.5) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 2 (100) | 0 (0) | 1 (50) | 0 (0) | 0 (0) |
≥ 26–28 | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
≥ 28 | 1 (0.7) | 0 (0) | 0 (0) | 1 (100) | 0 (0) | 1 (100) | 1 (100) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Total | 134 | 7 (5.2) | 3 (2.2) | 22 (16.4) | 2 (1.5) | 28 (20.9) | 72 (53.7) | 15 (11.2) | 12 (9.0) | 31 (23.1) | 15 (11.2) |
Recommended GWG for the 4 pre-pregnancy BMI groups
Subgroup of GWG (kg) | Number of participants with adverse pregnancy/total sub-layer participants (occurrence rate (%)) | |||
---|---|---|---|---|
Underweight | Normal weight | Overweight | Obesity | |
< 2 | 1/1 (100) | 12/14 (85.7) | 7/15 (46.7) | 6/9 (66.7) |
≥ 2–4 | 0/1 (0) | 5//10 (50.0) | 4/5 (80) | 2/3 (66.7) |
≥ 4–6 | 4/5 (80) | 25/38 (65.8) | 17/21 (81) | 2/3 (66.7) |
≥ 6–8 | 11/13 (84.6) | 41/55 (74.5) | 28/33 (84.8) | 10/15 (66.7) |
≥ 8–10 | 9/21 (42.9) | 83/123 (67.5) | 29/41 (69) | 12/15 (80) |
≥ 10–12 | 24/50 (48) | 205/316 (64.7) | 69/94 (73.4) | 22/30 (73.3) |
≥ 12–14 | 31/58 (53.4) | 196/328 (59.8) | 63/82 (76.8) | 11/15 (73.3) |
≥ 14–16 | 42/82 (50.6) | 278/424 (65.6) | 68/92 (73.1) | 14/16 (87.5) |
≥ 16–18 | 38/64 (59.4) | 155/240 (64.6) | 41/55 (74.5) | 10/11 (90.9) |
≥ 18–20 | 24/42 (57.1) | 123/191 (64.4) | 34/40 (85) | 5/9 (55.6) |
≥ 20–22 | 24/36 (66.7) | 114/163 (69.5) | 42/48 (87.5) | 3/3 (100) |
≥ 22–24 | 11/20 (55) | 48/68 (69.6) | 10/13 (76.9) | 2/2 (100) |
≥ 24–26 | 7/14 (50) | 33/49 (67.3) | 5/6 (83.3) | 2/2 (100) |
≥ 26–28 | 2/5 (40) | 13/19 (68.4) | 3/3 (100) | 0/0 (0) |
≥ 28 | 4/7 (57.1) | 15/21 (71.4) | 4/6 (66.7) | 1/1 (100) |
Comparison of overall occurrence rates of pregnant women with adverse pregnancy outcomes under the three recommended GWG criteria
Occurrence rates of pregnant women with adverse pregnancy outcomes n (%) | China (Occurrence Method) | Japan | IOM | ||||||
---|---|---|---|---|---|---|---|---|---|
Undergainers (n = 651) | Appropriate gainers (n = 706) | Overgainers (n = 1815) | Undergainers (n = 116) | Appropriate gainers (n = 791) | Overgainers (n = 2265) | Undergainers (n = 733) | Appropriate gainers (n = 1262) | Overgainers (n = 1177) | |
Total | 443 (68.1) | 429 (60.8) | 1232 (67.9) | 80 (69.0) | 510 (64.5) | 1514 (66.8) | 478 (65.2) | 800 (63.4) | 826 (70.2) |
PB | 55 (8.5) | 33 (4.7) | 63 (3.5) | 13 (11.2) | 57 (7.2) | 81 (3.6) | 60 (8.2) | 52 (4.1) | 128 (10.1) |
LBW | 41 (6.3) | 26 (3.7) | 45 (2.5) | 12 (10.3) | 41 (5.2) | 59 (2.6) | 44 (6.0) | 43 (3.4) | 26 (2.1) |
MAC | 23 (3.5) | 36 (5.1) | 164 (9.0) | 1 (0.9) | 29 (3.7) | 193 (8.5) | 24 (3.3) | 68 (5.4) | 39 (3.3) |
SGA | 52 (8.0) | 44 (6.2) | 86 (4.7) | 16 (13.8) | 55 (7.0) | 111 (4.9) | 57 (7.8) | 77 (6.1) | 25 (2.1) |
LGA | 39 (6.0) | 55 (7.8) | 240 (13.2) | 5 (4.3) | 50 (6.3) | 279 (12.3) | 43 (5.9) | 102 (8.1) | 131 (11.1) |
CS | 241 (37.0) | 265 (37.5) | 823 (45.3) | 45 (38.8) | 285 (36.0) | 999 (44.1) | 260 (35.5) | 502 (39.8) | 48 (4.1) |
GA | 94 (14.4) | 97 (13.7) | 252 (13.9) | 13 (11.2) | 112 (14.2) | 318 (14.0) | 99 (13.5) | 186 (14.7) | 189 (16.1) |
PROM | 93 (14.3) | 84 (11.9) | 221 (12.2) | 13 (11.2) | 108 (13.7) | 277 (12.2) | 101 (13.8) | 140 (11.1) | 567 (48.2) |
GDM | 110 (16.9) | 72 (10.2) | 190 (10.5) | 17 (14.7) | 116 (14.7) | 239 (10.6) | 117 (16.0) | 52 (4.1) | 158 (13.4) |
GH | 12 (1.8) | 13 (1.8) | 59 (3.3) | 1 (0.9) | 14 (1.8) | 69 (3.0) | 12 (1.6) | 43 (3.4) | 157 (13.3) |