Dataset Information

Development and evaluation of percentile distribution of body weight by gestational week as a tool for gestational weight management: a retrospective study based on hospital routine data.

ABSTRACT:

Objectives

This study aimed to construct and validate smoothed gestational weight centile curves based on preconception weight status for Chinese pregnant women.

Design

A retrospective study based on hospital routine data SETTING: Hospital prenatal care.

Population

A cohort of pregnant Chinese women with preconception and gestational body weights without maternal or neonatal complications (sample 1, n=2992), and a non-selective independent sample (sample 2, n=7420), were selected from hospital routine data for curve construction and validation.

Study design

Smoothed body weight centile curves for each gestational week were constructed using the LMS method in sample 1. Validation in sample 2 included analysis of agreement between predicted weight at the 38th week and observed values using the Bland-Altman Index. Predictions were also compared with international curves.

Results

Smoothed centile curves of gestational weight for the three preconception body mass index groups showed a similar non-linear increasing trend. The differences between predicted body weights and observed values were 0.66±1.58 kg, 0.14±1.61 kg and -0.54±2.06?kg in the underweight, normal weight and overweight groups, respectively. Bland-Altman Index values were 5.2%, 5.6% and 4.7% in the underweight, normal weight and overweight groups, respectively, with limits of agreement of -2.4~3.8 kg, -3.0~3.3?kg and -4.4~3.4?kg, respectively. These limits of agreement were narrower than those of available international curves.

Conclusion

Body weight percentiles for gestational weeks 0-42 were proposed for underweight, normal weight or overweight Chinese women. These curves could constitute a useful tool for individualised gestational weight management by predicting body weight at a later gestation phase.

SUBMITTER: Zhang Y

PROVIDER: S-EPMC6135441 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Publications

Development and evaluation of percentile distribution of body weight by gestational week as a tool for gestational weight management: a retrospective study based on hospital routine data.

Zhang Yi Y Wang Liping L Yin Chuanmin C Mu Kai K Niu Dayan D Yan Weili W

BMJ open 20180628 6

<h4>Objectives</h4>This study aimed to construct and validate smoothed gestational weight centile curves based on preconception weight status for Chinese pregnant women.<h4>Design</h4>A retrospective study based on hospital routine data SETTING: Hospital prenatal care.<h4>Population</h4>A cohort of pregnant Chinese women with preconception and gestational body weights without maternal or neonatal complications (sample 1, n=2992), and a non-selective independent sample (sample 2, n=7420), were se ...[more]

PMID: 29959145

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Project description:BACKGROUND:In clinical practice, there is the diffuse conviction that obese subjects with metabolic syndrome may be more difficult to treat. OBJECTIVES AND METHODS:The aim of the present study was that to investigate the effectiveness of a 3-week in-hospital body weight reduction program (BWRP) in a large population of obese subjects with and without metabolic syndrome (n = 1922; 222 men and 1700 women, age range 18-83 yr). Outcomes such as body mass index (BMI), total (TOT) and HDL cholesterol, systolic and diastolic blood pressures (SBP and DBP, respectively), coronary heart disease (CHD) score, fatigue severity score (FSS), and stair climbing test (SCT) time were evaluated before and after the intervention (?). A sex-, BMI-, and age-related stratification of the obese population with or without metabolic syndrome was applied. RESULTS:When compared to obese subjects without metabolic syndrome, at the basal conditions, obese subjects had a poorer cardiometabolic profile, as demonstrated by higher triglycerides, TOT-cholesterol, DBP, SBP, and CHD score, and a more compromised muscle performance (evaluated by SCT), associated with more perception of fatigue (measured by FSS). Nevertheless, obese subjects with metabolic syndrome obtained more benefits from BWRP than those without metabolic syndrome for some outcomes (i.e., ?TOT-cholesterol, ?SBP, and ?CHD score). Despite these differences, the BWRP-induced weight loss was similar between the two groups (i.e., ?BMI) as well as the gain of muscle performance (i.e., ?SCT) and the reduction of fatigue (i.e., ?FSS). Interestingly, the potentially deleterious fall in HDL-cholesterol levels after BWRP was less evident in obese subjects with metabolic syndrome than those without metabolic syndrome. When pooling all data, the ?CHD score was associated with age, sex, and metabolic syndrome. The remaining outcomes, such as ?BMI, ?FSS, and ?SCT time, were associated with sex and age but not with metabolic syndrome. Finally, ?BMI was positively correlated with ?CHD score, ?FSS, and ?SCT time in both obese subjects without metabolic syndrome and obese subjects with metabolic syndrome. CONCLUSIONS:When comparing obese subjects undergoing a BWRP, metabolic syndrome is not a negative predictive factor affecting the effectiveness of this intervention in terms of weight loss, muscle performance, and psychological well-being.

Project description:OBJECTIVE:To study the association of prepregnancy body mass index (BMI) and gestational weight gain with child neurodevelopmental outcomes. METHODS:We performed a secondary analysis of data from two parallel, multicenter, randomized, double-blind, placebo-controlled thyroxine replacement trials in pregnant women with either hypothyroxinemia or subclinical hypothyroidism who delivered at term. Body mass index was categorized as normal (18.5-24.9), overweight (25.0-29.9), or obese (30 or greater). We also evaluated early (20 weeks of gestation or less), late (greater than 20 weeks of gestation), and total gestational weight gain and categorized gestational weight gain as inadequate, adequate, and excessive per 2009 Institute of Medicine guidelines. Neurodevelopmental outcomes included 5-year Wechsler Preschool and Primary Scale of Intelligence and 3-year Differential Ability Scales-II. Linear and logistic regression analyses were performed and adjusted for maternal age, race-ethnicity, education, insurance status, parity, smoking and alcohol use, thyroid status (subclinical hypothyroidism or hypothyroxinemia), treatment group, gestational age at delivery, and neonatal sex. RESULTS:Of the 948 women included, 380 (40%), 305 (32%), and 263 (28%) had normal, overweight, and obese prepregnancy BMI, respectively. A total of 106 (11%), 212 (22%), and 630 (66%) of women had inadequate, adequate, and excessive total rates of gestational weight gain, respectively. Maternal differences among the BMI categories included race-ethnicity, education, insurance type, parity, and thyroid status (all P<.01), whereas the gestational weight gain groups only differed by parity (P<.001). In unadjusted analysis, children of obese (93.2±12.8; 88.5±13.3) and overweight (94.1±15.6; 89.6±16.0) women had lower Wechsler Preschool and Primary Scale of Intelligence and Differential Ability Scales-II scores, respectively, than normal-weight women (97.4±15.4; 93.9±16.0; P<.001 for all comparisons); however, in adjusted analysis, there were no differences in neurodevelopmental outcomes by maternal BMI. The association was primarily accounted for by race-ethnicity and education. In unadjusted and adjusted analyses, there were no differences in neurodevelopmental outcomes by adequacy of early, late, or total gestational weight gain. CONCLUSION:In women with either subclinical hypothyroidism or hypothyroxinemia, neither prepregnancy BMI nor gestational weight gain was associated with neurodevelopmental outcomes among children born at term in adjusted analyses.

Dataset Information

Development and evaluation of percentile distribution of body weight by gestational week as a tool for gestational weight management: a retrospective study based on hospital routine data.

Objectives

Design

Population

Study design

Results

Conclusion

Publications

Development and evaluation of percentile distribution of body weight by gestational week as a tool for gestational weight management: a retrospective study based on hospital routine data.

Similar Datasets

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