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- Title
Gestational weight trajectory and risk of adverse pregnancy outcomes among women with gestational diabetes mellitus: A retrospective cohort study.
- Authors
Lin, Lihua; Huang, Yanhong; Chen, Lijuan; Zheng, Lianghui; Feng, Yebin; Lin, Juan; Yan, Jianying
- Abstract
The aim of this study was to explore gestational weight gain (GWG) trajectories and their associations with adverse pregnancy outcomes. A retrospective cohort study including 11,064 women with gestational diabetes mellitus (GDM) was conducted between 2015 and 2019 in China. The latent class trajectory model was used to identify GWG trajectories, and logistic regression was performed to examine odds ratio (OR) of pregnancy outcomes. Three trajectories of GWG were identified in these 11,604 women with GDM. Trajectory 1: 64.02% of women had sustained moderate GWG throughout pregnancy; Trajectory 2: 17.75% of women showed a high initial GWG but followed by a low GWG from the third trimester until delivery; Trajectory 3: 18.23% had low initial GWG but followed by drastic GWG from the second trimester until delivery. Compared with pregnant women with Trajectory 1, women with Trajectory 2 had a higher risk of large for gestational age (adjusted odds ratio [AOR]: 1.29, 95% confidence interval [CI]: 1.12–1.48) but at a lower risk of having hypertensive disorders of pregnancy (AOR: 0.76, 95% CI: 0.57–0.96). Women in Trajectory 3 were more likely to develop small for gestational age (AOR: 2.12, 95% CI: 1.62–2.78), low birthweight (AOR: 1.49, 95% CI: 1.07–2.08), preterm birth (AOR: 1.28, 95% CI: 1.05–1.63), caesarean section (AOR: 1.26, 95% CI: 1.112–1.42) and hypertensive disorders of pregnancy (AOR: 2.24, 95% CI: 1.82–2.76). The association of GWG trajectory with adverse pregnancy outcomes differs across prepregnancy body mass index and GWG categories. Women with a slow initial GWG but followed by drastic GWG had higher risks of adverse pregnancy outcomes. Early clinical recognition of poor GWG trajectory will contribute to early intervention in high‐risk groups to minimise adverse outcomes. Key messages: Gestational weight gain (GWG) is a controllable factor and is strongly associated with maternal and fetal outcomes, especially among gestational diabetes mellitus.The same total GWG may present different trajectories, and the trajectory patterns of GWG vary with women in different body mass index categories.Clarifying the relationship between GWG trajectory and adverse pregnancy outcomes may contribute to the clear goal of lifestyle interventions based on weight control.Early recognition of an unhealthy GWG trajectory may contribute to early intervention in high‐risk groups to minimise adverse outcomes.
- Subjects
RISK assessment; WEIGHT gain in pregnancy; RESEARCH funding; GESTATIONAL diabetes; SCIENTIFIC observation; LOGISTIC regression analysis; PREGNANCY outcomes; RETROSPECTIVE studies; STRUCTURAL equation modeling; DESCRIPTIVE statistics; CHI-squared test; LONGITUDINAL method; ODDS ratio; MEDICAL records; ACQUISITION of data; ANALYSIS of variance; CONFIDENCE intervals; DATA analysis software
- Publication
Maternal & Child Nutrition, 2024, Vol 20, Issue 3, p1
- ISSN
1740-8695
- Publication type
Article
- DOI
10.1111/mcn.13645