Chinese study: What is the optimal criteria for weight gain during pregnancy?

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without permission.

Maternal weight gain (GWG) during pregnancy is closely related to pregnancy outcomes, and excessive or insufficient GWG can adversely affect pregnancy outcomes and even affect the health of
offspring.
Recently, a study based on Chinese groups found that GWG in pregnant women with gestational diabetes mellitus (GDM) in China increased, and pregnant women in China were more sensitive
to the optimal weight gain value than previous guideline recommendations.
The findings were published in J Obstet Gynaecol Res
.

According to the specific BMI classification in China, the optimal GWG range is as follows: ➤The optimal GWG range for underweight women is 11.
0-17.
5kg; ➤ Normal weight women are 3.
7-9.
7kg; ➤Overweight women are -0.
6~4.
8kg➤Obese women are -9.
8~4.
2kg
.

The GWG standards for pregnant women with pre-pregnancy BMI are different in international and domestic countries

At present, China's gestational weight management standards are implemented in the "Recommended Standards for Weight Growth of Pregnant Women" issued by the National Health Commission in July 2022, and the specific recommendations are shown in Table 1
.

Source: People's Republic of China Health Industry Standard WS/T801—2022

According to the 2009 recommended standards of the American Institute of Medicine (IOM), there are some differences
with the existing standards in China.

Source: IOM

The study included a total of 8103 pregnant women with GDM from 2017 to 2020, used a quadratic function model and the overall predicted probability of adverse pregnancy outcomes to obtain optimal GWG, and analysed the difference
in the incidence of adverse pregnancy outcomes between the optimal GWG recommendation and the IOM 2009 GWG guidelines.

China's best GWG, more sensitive than international

1.
According to the specific BMI classification in China, the optimal GWG range is as follows:

➤ The optimal GWG range for underweight women is 11.
0-17.
5kg;

➤ Normal weight women are 3.
7-9.
7kg;

➤ -0.
6~4.
8kg for overweight women

➤ Obese women are -9.
8~4.
2kg
.

2.
Impact of GWG excess:

➤ Have a higher large-for-gestational age (LGA) (OR: 2.
99, 95% CI 2.
42–3.
70);

➤ macrosomal risk (OR: 2.
35, 95% CI 1.
77–3.
12);

➤ risk of pre-eclampsia (OR: 1.
91, 95% CI 1.
37–2.
65);

➤ risk of hypertension during pregnancy (OR: 1.
65, 95% CI 1.
24–2.
19);

➤ risk of caesarean section (OR: 1.
29, 95% CI 1.
15–1.
44);

➤ Risk of postpartum haemorrhage (OR: 1.
29, 95% CI 1.
02–1.
64).

3.
Impact of GWG deficiency:

➤ small-for-gestational-age infants were at higher risk (OR: 1.
82, 95% CI 1.
20 to 2.
75); ➤ Compared with the IOM 2009 GWG guidelines, the prevalence of macrosomia, LGA, and postpartum hemorrhage were significantly reduced in GWG (P <0.
05).

brief summary

The study found a specific BMI classification in China and compared the IOM 2009 GWG guidelines and found that pregnant women in China were more sensitive
to the best GWG recommendations.

Source: Fan X, Dai J, He J, et al.
Optimal gestational weight gain in Chinese pregnant women with gestational diabetes mellitus: A large retrospective cohort study [published online ahead of print, 2022 Oct 2].
J Obstet Gynaecol Res.
2022; 10.
1111/jog.
15448.
doi:10.
1111/jog.
15448