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Frontiers in public health
2024;12 1354355.

Pre-pregnancy body mass index, gestational diabetes mellitus, and gestational weight gain: individual and combined effects on fetal growth.

Yanyu Lyu, Mingming Cui, Lingling Zhang, Guang Zheng, Hanxiao Zuo, Qingyong Xiu, Prakesh S Shah
Author Information
  1. Yanyu Lyu: Experiment Center, Capital Institute of Pediatrics, Beijing, China.
  2. Mingming Cui: Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China.
  3. Lingling Zhang: Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, United States.
  4. Guang Zheng: School of Information Science and Engineering, Lanzhou University, Lanzhou, China.
  5. Hanxiao Zuo: School of Public Health, University of Alberta, Edmonton, AB, Canada.
  6. Qingyong Xiu: Department of Pediatrics, Beijing Daxing Maternal and Child Care Hospital, Beijing, China.
  7. Prakesh S Shah: Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada.
PMID: 38528861 DOI: 10.3389/fpubh.2024.1354355

Abstract

Background: Pre-pregnancy body mass index (BMI), gestational diabetes mellitus (GDM), and gestational weight gain (GWG) are interlinked and may play a complex role in fetal growth. We aimed to examine the relationship between pre-pregnancy BMI, GDM, GWG, and fetal growth outcomes and explore the contribution of GDM and GWG to the relationship between Pre-pregnancy obesity/overweight and large-for-gestational-age (LGA) in a prospective cohort.
Methods: We prospectively recruited women in the first trimester and having one-step GDM screened with a 75-g oral glucose tolerance test between 24 and 28���weeks of gestation (���=���802). Outcomes included LGA, small-for-gestational-age (SGA), and preterm birth. To assess the individual and cumulative associations between pre-pregnancy BMI, GDM, GWG, and these outcomes, we used multivariate logistic regression analysis. Furthermore, we employed structural equation modeling (SEM) to investigate the mediating role of GDM and excessive GWG in the correlation between pre-pregnancy overweight/obesity and LGA.
Results: Pre-pregnancy obesity, GDM, and excessive GWG were all independently associated with increased odds of LGA. Inadequate GWG was associated with higher odds of preterm birth. Compared with women unexposed to pre-pregnancy overweight/obesity, GDM, or excessive GWG, women exposed any two conditions had higher odds for LGA (AOR 3.18, 95% CI 1.25-8.11) and women with coexistence of all had the highest odds for LGA (AOR 8.09, 95% CI 2.18-29.97). The mediation analysis showed that GDM explained 18.60% (���<���0.05) of the total effect of pre-pregnancy overweight/obesity on LGA, and GWG explained 17.44% (���<���0.05) of the total effect.
Conclusion: Pre-pregnancy obesity/overweight, GDM, and excessive GWG are associated with higher odds of fetal growth disturbances as individual factors and when they co-exist. The effect of pre-pregnancy overweight/obesity on LGA is partially achieved through GDM and excessive GWG.

Keywords

birth cohort gestational diabetes mellitus gestational weight gain large-for-gestational-age mediation analysis pre-pregnancy body mass index preterm birth

References

  1. Nat Rev Neurosci. 2013 May;14(5):365-76 [PMID: 23571845]
  2. BMC Pediatr. 2013 Apr 20;13:59 [PMID: 23601190]
  3. Obstet Gynecol. 2010 Feb;115(2 Pt 1):331-337 [PMID: 20093907]
  4. J Intern Med. 2007 May;261(5):412-7 [PMID: 17444880]
  5. J Obstet Gynaecol Can. 2011 Dec;33(12):1223-1233 [PMID: 22166276]
  6. Diabetes Care. 2010 Mar;33(3):676-82 [PMID: 20190296]
  7. Wei Sheng Yan Jiu. 2019 Mar;48(2):193-199 [PMID: 31133094]
  8. J Obstet Gynaecol. 2016;36(3):328-32 [PMID: 26492517]
  9. J Obstet Gynaecol Can. 2013 Sep;35(9):802-809 [PMID: 24099445]
  10. PLoS One. 2018 Jul 12;13(7):e0200361 [PMID: 30001386]
  11. JAMA. 2021 Dec 28;326(24):2498-2506 [PMID: 34962526]
  12. BMC Pregnancy Childbirth. 2020 Nov 12;20(1):690 [PMID: 33183261]
  13. Int J Clin Exp Med. 2015 Feb 15;8(2):2881-6 [PMID: 25932249]
  14. BMC Pregnancy Childbirth. 2017 Nov 28;17(1):396 [PMID: 29179683]
  15. Lancet. 2004 Jan 10;363(9403):157-63 [PMID: 14726171]
  16. Int J Environ Res Public Health. 2020 Dec 18;17(24): [PMID: 33353136]
  17. Diabetes Res Clin Pract. 2018 Oct;144:286-293 [PMID: 30189224]
  18. Curr Opin Endocrinol Diabetes Obes. 2014 Aug;21(4):257-63 [PMID: 24937039]
  19. Curr Diab Rep. 2020 Feb 27;20(3):11 [PMID: 32108283]
  20. BMC Pregnancy Childbirth. 2022 Apr 18;22(1):333 [PMID: 35436866]
  21. Obstet Gynecol. 2014 Apr;123(4):737-44 [PMID: 24785599]
  22. Obesity (Silver Spring). 2018 Aug;26(8):1347-1356 [PMID: 29931812]
  23. PLoS One. 2015 Mar 23;10(3):e0121029 [PMID: 25799433]
  24. Endocrinol Diabetes Metab. 2021 Oct;4(4):e00285 [PMID: 34505412]
  25. BMC Med. 2020 Oct 2;18(1):276 [PMID: 33004027]
  26. Am J Obstet Gynecol. 2017 Dec;217(6):642-651 [PMID: 28549978]
  27. BJOG. 2019 Jul;126(8):984-995 [PMID: 30786138]
  28. Obes Rev. 2009 Mar;10(2):194-203 [PMID: 19055539]
  29. Clin Nutr ESPEN. 2021 Apr;42:307-312 [PMID: 33745597]
  30. Obstet Gynecol. 2011 Aug;118(2 Pt 1):305-312 [PMID: 21775846]
  31. Diabetes Care. 2013 Jan;36(1):56-62 [PMID: 22891256]
  32. Front Nutr. 2022 Feb 17;9:789833 [PMID: 35252291]
  33. Ann Nutr Metab. 2019;75(1):31-38 [PMID: 31302647]
  34. Front Nutr. 2022 Aug 24;9:980853 [PMID: 36091237]
  35. PLoS One. 2013 Apr 16;8(4):e61627 [PMID: 23613888]

MeSH Term

Pregnancy
Infant, Newborn
Female
Humans
Diabetes, Gestational
Overweight
Gestational Weight Gain
Body Mass Index
Pregnancy Outcome
Premature Birth
Prospective Studies
Weight Gain
Obesity
Fetal Development
Journal Article Research Support, Non-U.S. Gov't
Article has an altmetric score of 1

Word Cloud

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