Association Of Pre-pregnancy Body Mass Index And Weight Gain During Pregnancy On The Macrosomia And Overweight And Obesity At The Age Of Two

ObjectiveTo describe the status of the pre-pregnancy body mass index?BMI?,weight gain during pregnancy,and examine the relationship of the pre-pregnancy overweight obesity,weight gain during pregnancy and the macrosomia and overweight and obesity at the age of two.MethodsThe pregnant women who accepted health care in maanshan maternity and child health care between January 1,2011 to October 31,2012 were selected to enter the cohort after according with the inclusion and exclusion standard.They were followed-up during pregnancy and the health care was recorded.The birth of baby was recorded after birth,and the related situation of their parents were investigated.Then,the follow-up investigation was conducted when the baby was 3 months,6 months,9months and 12 months when their mothers came to hospital.The last investigation was when the baby at the age of 2,the length and weight was measured and recorded.The pre-pregnancy BMI was divided into 4 grades using WGOC standard(<18.5 kg/m²,18.5²3.9 kg/m²,23.9²7.9 kg/m² and 28.0 kg/m²)which were defined as emaciation,normal weight,overweight and obesity,respectively;the BMI standard of weight gain during pregnancy was divided into 4 kinds of circumstances by the Institute of Medicine?IOM?,when the pre-pregnancy BMI was<18.5 kg/m²,18.5²3.9 kg/m²,24.0²7.9 kg/m²and 28.0 kg/m²,respectively,the weight range was 12.5¹8.0 kg,11.5¹6.0 kg,7.0¹1.5kg,5⁹ kg,respectively.So if weight gain during pregnancy within the scope was moderate,below the lower limit value of scope was less weight gain during pregnancy,above the upper limit value of scope was more weight gain during pregnancy.The z-score method was used to evaluate the weight status of children when they were 2 years old,and defined the BMI Z value of<-2 as wasting or severely wasting,-2² as normal,>2 as being overweight,and>3 as being obese.The multi-factor logistics regression was used to examine the RR of the pre-pregnancy overweight obesity,weight gain during pregnancy and the macrosomia and overweight and obesity at the age of two..ResultsA total of 1773 pregnant women were selected to enter the cohort,but 75 were out of statistics demand,including lost to follow-up,miscarriages and other cases.A total of29 people lost to follow-up at the 2 years follow-up,the rate was 1.8%.Among the 1658pregnant women,low pre-pregnancy body mass index were 402?24.2%?,normal were1111?67.0%?,overweight and obesity were 145?8.7%?.Low weight gain during pregnancy was 293?17.7%?,modest were 505?30.5%?,and larger were 859 people?51.8%?.Among the 402 pregnant women who were low pre-pregnancy body mass index,the low,modest,larger weight gain during pregnancy were 48?12.0%?,169?42.0%?and 185?46.0%?,respectively;the 1110 pregnant women who were normal were 190?17.1%?,322?29.0%?and 598?53.9%?,respectively;the 145 pregnant women who were overweight and obesity were 55?37.9%?,14?9.7%?and 76?52.4%?,respectively.Among 1658 babies,low birth weight were 8?0.5%?,normal were 1477?89.1%?,macrosomia were 173?10.4%?.Among the 2 years-old children,Z score method was used to calculate the Z values of body mass index,only 1 is wasting or severely wasting,98?6.0%?were obese,the remaining 1530 were normal?93.9%?.After adjusting the confounding factors,the results of multiple factors regression analysis showed that the pre-pregnancy overweight and obesity was the independent risk factor of macrosomia?RR:1.67,95%CI:1.03-2.71?and the overweight obesity when children at 2 years old?RR:2.00,95%CI:1.13-3.53?.The excessive weight gain during pregnancy also was the independent risk factor of macrosomia?RR:2.30,95%CI:1.52-3.49?and the overweight obesity when children at 2 years old?RR:1.80,95%CI:1.05-3.08?.ConclusionThe incidence of macrosomia,overweight obesity when children were 2 years old,pre-pregnancy overweight obesity,and excess weight gain during pregnancy rates were at a moderate level.The higher pre-pregnancy body mass index and greater weight gain during pregnancy were the risk factor of macrosomia and the overweight obesity when children at 2 years old.Therefore,the publicity of weight control should be conducted before pregnancy and we should strengthen to formulate the personalized weight control scheme during pregnancy.