https://orcid.org/0000-0001-6770-1838
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ABSTRACT
Background
The 2009 Institute of Medicine (IOM) gestational weight gain (GWG) guidelines were initially developed for pregnant women in the United States.
Objective
This study aimed to investigate whether the IOM guidelines were suitable for pregnant Chinese women.
Methods
A retrospective cohort study comprising 20,593 singleton pregnant women was conducted at the Beijing Obstetrics and Gynaecology Hospital (1 January 2018 to 31 December 2019). Applicability was evaluated by comparing the GWG corresponding to the lowest point of the predicted composite risk curve with the 2009 IOM GWG Guidelines. The IOM Guidelines serve as the standard for the GWG categories and the pre-pregnancy body mass index. An exponential function model was used to fit the weight gain during pregnancy and the probability of caesarean section, preterm birth, small for gestational age, and large for gestational age. A quadratic function model was used to fit the combined probability of the above-mentioned adverse pregnancy outcomes. The applicability of the IOM guidelines was evaluated by comparing the weights corresponding to the lowest predicted probability with the GWG range recommended by the IOM guidelines.
Results
According to the 2009 IOM GWG Guidelines, 43% of the women achieved adequate weight, almost 32% gained excessive weight, and 25% gained inadequate weight. The GWG range proposed by the IOM included the lowest predicted probability value for underweight women and exceeded the lowest predicted probability for normal weight, overweight, and obese women.
Conclusions
The 2009 IOM guidelines were suitable for Chinese women whose pre-pregnancy body mass index was classified as underweight. The guidelines were not suitable for normal, overweight, or obese pre-pregnancy body mass index classifications. Therefore, based on the above evidence, the 2009 IOM guidelines are not suitable for all Chinese women.
Responsible Editor Jennifer Stewart Williams
Responsible Editor Jennifer Stewart Williams
Acknowledgments
The authors thank professors Huili Wang and Haili Jiang for their guidance.
Author contributions
HW and HJ conceptualised this manuscript. YJ, CZ, YL, and XW performed data collection. YJ and HW conducted the statistical analysis. YJ and HJ wrote the first draft of the manuscript. HW and HJ critically revised the manuscript. All authors have read and approved the final version of the manuscript.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Ethics and consent
The Medical Ethics Committee of Beijing Obstetrics and Gynaecology Hospital, Beijing, China, approved the study. The approval number: 2022-KY-019-01. All subjects provided verbal and fully informed consent.
Paper context
The 2009 Institute of Medicine Gestational Weight Gain guidelines, originally developed for pregnant women in the United States, are commonly used worldwide. There is no current authoritative gestational weight gain range recommended for Chinese women. This study of more than 20,000 pregnant Chinese women found that these established guidelines were not suitable for all Chinese women.