Pre-pregnancy body mass index, gestational diabetes mellitus, and gestational weight gain: individual and combined effects on fetal growth
BackgroundPre-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 contr...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-03-01
|
| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1354355/full |
| _version_ | 1797266412640665600 |
|---|---|
| author | Yanyu Lyu Mingming Cui Lingling Zhang Guang Zheng Hanxiao Zuo Qingyong Xiu Prakesh S. Shah |
| author_facet | Yanyu Lyu Mingming Cui Lingling Zhang Guang Zheng Hanxiao Zuo Qingyong Xiu Prakesh S. Shah |
| author_sort | Yanyu Lyu |
| collection | DOAJ |
| description | BackgroundPre-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.MethodsWe 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 (n = 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.ResultsPre-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% (p < 0.05) of the total effect of pre-pregnancy overweight/obesity on LGA, and GWG explained 17.44% (p < 0.05) of the total effect.ConclusionPre-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. |
| first_indexed | 2024-04-25T01:00:17Z |
| format | Article |
| id | doaj.art-33cda7d3b73b49b792996313ffb55aa0 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-25T01:00:17Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-33cda7d3b73b49b792996313ffb55aa02024-03-11T04:53:06ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-03-011210.3389/fpubh.2024.13543551354355Pre-pregnancy body mass index, gestational diabetes mellitus, and gestational weight gain: individual and combined effects on fetal growthYanyu Lyu0Mingming Cui1Lingling Zhang2Guang Zheng3Hanxiao Zuo4Qingyong Xiu5Prakesh S. Shah6Experiment Center, Capital Institute of Pediatrics, Beijing, ChinaBeijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, ChinaRobert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, United StatesSchool of Information Science and Engineering, Lanzhou University, Lanzhou, ChinaSchool of Public Health, University of Alberta, Edmonton, AB, CanadaDepartment of Pediatrics, Beijing Daxing Maternal and Child Care Hospital, Beijing, ChinaDepartment of Pediatrics, Mount Sinai Hospital, Toronto, ON, CanadaBackgroundPre-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.MethodsWe 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 (n = 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.ResultsPre-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% (p < 0.05) of the total effect of pre-pregnancy overweight/obesity on LGA, and GWG explained 17.44% (p < 0.05) of the total effect.ConclusionPre-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.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1354355/fullpre-pregnancy body mass indexgestational diabetes mellitusgestational weight gainlarge-for-gestational-agepreterm birthbirth cohort |
| spellingShingle | Yanyu Lyu Mingming Cui Lingling Zhang Guang Zheng Hanxiao Zuo Qingyong Xiu Prakesh S. Shah Pre-pregnancy body mass index, gestational diabetes mellitus, and gestational weight gain: individual and combined effects on fetal growth Frontiers in Public Health pre-pregnancy body mass index gestational diabetes mellitus gestational weight gain large-for-gestational-age preterm birth birth cohort |
| title | Pre-pregnancy body mass index, gestational diabetes mellitus, and gestational weight gain: individual and combined effects on fetal growth |
| title_full | Pre-pregnancy body mass index, gestational diabetes mellitus, and gestational weight gain: individual and combined effects on fetal growth |
| title_fullStr | Pre-pregnancy body mass index, gestational diabetes mellitus, and gestational weight gain: individual and combined effects on fetal growth |
| title_full_unstemmed | Pre-pregnancy body mass index, gestational diabetes mellitus, and gestational weight gain: individual and combined effects on fetal growth |
| title_short | Pre-pregnancy body mass index, gestational diabetes mellitus, and gestational weight gain: individual and combined effects on fetal growth |
| title_sort | pre pregnancy body mass index gestational diabetes mellitus and gestational weight gain individual and combined effects on fetal growth |
| topic | pre-pregnancy body mass index gestational diabetes mellitus gestational weight gain large-for-gestational-age preterm birth birth cohort |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1354355/full |
| work_keys_str_mv | AT yanyulyu prepregnancybodymassindexgestationaldiabetesmellitusandgestationalweightgainindividualandcombinedeffectsonfetalgrowth AT mingmingcui prepregnancybodymassindexgestationaldiabetesmellitusandgestationalweightgainindividualandcombinedeffectsonfetalgrowth AT linglingzhang prepregnancybodymassindexgestationaldiabetesmellitusandgestationalweightgainindividualandcombinedeffectsonfetalgrowth AT guangzheng prepregnancybodymassindexgestationaldiabetesmellitusandgestationalweightgainindividualandcombinedeffectsonfetalgrowth AT hanxiaozuo prepregnancybodymassindexgestationaldiabetesmellitusandgestationalweightgainindividualandcombinedeffectsonfetalgrowth AT qingyongxiu prepregnancybodymassindexgestationaldiabetesmellitusandgestationalweightgainindividualandcombinedeffectsonfetalgrowth AT prakeshsshah prepregnancybodymassindexgestationaldiabetesmellitusandgestationalweightgainindividualandcombinedeffectsonfetalgrowth |