1
|
Dai J, Fan X, He J, Tian R, Xu J, Song J, Chen X, Han L, Chen Y, Peng L, Cao Q, Bai J, Chen Z, Liu Y, Zou Z, Chen X. Is the Gestational Weight Gain Recommended by the National Academy of Medicine Guidelines Suitable for Chinese Twin-Pregnant Women with Gestational Diabetes Mellitus? Am J Perinatol 2024; 41:e331-e340. [PMID: 36113492 DOI: 10.1055/s-0042-1754319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES This study aimed to assess the applicability of the National Academy of Medicine (NAM) interim guidelines for twin pregnancies to the specific population of gestational diabetes mellitus by exploring the relationship between gestational weight gain and adverse pregnancy outcomes in Chinese twin-pregnant women with gestational diabetes mellitus. STUDY DESIGN This was a retrospective cohort study of women diagnosed with diabetes in pregnancy between July 2017 and December 2020 at the Maternal and Child Health Hospital in Chongqing, China. The primary variable of interest was maternal total gestational weight gain. The primary outcomes were perinatal outcomes, which included: preeclampsia, small for gestational age, large for gestational age, low birth weight, neonatal pneumonia, neonatal respiratory distress syndrome, and neonatal intensive unit admission, etc. The association between inappropriate gestational weight gain and adverse pregnancy outcomes was estimated using multiple logistic regression analysis. RESULTS A total of 455 twin-pregnant women who had gestational diabetes mellitus were analyzed. Women with low gestational weight gain had reduced risk of preeclampsia (adjusted odds ratio [aOR], 0.32; 95% CI or confidence interval, 0.17-0.63; p = 0.001) and their infants had higher risks of small for gestational age (aOR, 1.93; 95% CI, 1.04-3.58; p = 0.037), low birth weight (aOR, 2.27; 95% CI, 1.32-3.90; p = 0.003), neonatal intensive unit admission (aOR, 3.29; 95% CI, 1.10-5.78; p = 0.038), pneumonia (aOR, 2.41; 95% CI, 1.08-5.33; p = 0.031), and neonatal respiratory distress syndrome (aOR, 2.29; 95% CI, 1.10-4.78; p = 0.027); the infants of women with excessive gestational weight gain had a higher risk of large for gestational age (aOR, 3.76; 95% CI, 1.42-9.96; p = 0.008). CONCLUSION Gestational weight gain controlled within the range recommended by the NAM could reduce the risk of perinatal adverse outcomes. The 2009 NAM gestational weight gain recommendations can be used for Chinese twin-pregnant women with gestational diabetes mellitus. KEY POINTS · Inappropriate gestational weight gain can lead to adverse perinatal outcomes in twin pregnancies.. · Gestational weight gain controlled within recommended range could reduce the risk of poor perinatal outcomes.. · The National Academy of Medicine recommendations are suitable for Chinese twin-pregnant women with GDM..
Collapse
Affiliation(s)
- Jiamiao Dai
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Xiaoxiao Fan
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Jing He
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Ruixue Tian
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Jingqi Xu
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Jiayang Song
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Xiangxu Chen
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Lu Han
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Yanlin Chen
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Li Peng
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Qiongya Cao
- School of Nursing, Hubei University of Medicine, Shiyan, Hubei, China
| | - Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Zhen Chen
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China
| | - Yanqun Liu
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Zhijie Zou
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Xiaoli Chen
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| |
Collapse
|
2
|
Wierzejska RE. Review of Dietary Recommendations for Twin Pregnancy: Does Nutrition Science Keep Up with the Growing Incidence of Multiple Gestations? Nutrients 2022; 14:1143. [PMID: 35334799 PMCID: PMC8953105 DOI: 10.3390/nu14061143] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 02/04/2023] Open
Abstract
Recommendations for nutrition and the use of dietary supplements for pregnant women are updated on regular basis but it remains to be seen to what extent they may be applicable in twin pregnancies. The aim of this narrative review is to present the current state of knowledge about the energy and nutrient demand in twin pregnancy. There is general consensus in literature that the energy demand is higher than in a singleton pregnancy, but there is a lack of position statements from scientific societies on specific energy intake that is required. In turn, recommended maternal weight gain, which favors the normal weight of the neonate, has been determined. There is even a larger knowledge gap when it comes to vitamins and minerals, the body stores of which are theoretically used up faster. The greatest number of studies so far focused on vitamin D, and most of them concluded that its concentration in maternal blood is lower in twin as compared to singleton pregnancy. Few randomized studies focus on iron supplementation and there are no other studies that would assess dietary interventions. In light of a growing incidence of multiple pregnancies, more studies are necessary to establish the nutritional demands of the mother and the course of action for adequate supplementation.
Collapse
Affiliation(s)
- Regina Ewa Wierzejska
- Department of Nutrition and Nutritional Value of Food, National Institute of Public Health NIH-National Research Institute, Chocimska St. 24, 00-791 Warsaw, Poland
| |
Collapse
|
3
|
Clinical Observation of Effects of Prepregnancy Body Mass Index and Weight Gain during Pregnancy on Neonatal Weight and Delivery Outcome. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8323189. [PMID: 34616482 PMCID: PMC8487824 DOI: 10.1155/2021/8323189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/02/2021] [Indexed: 11/17/2022]
Abstract
Objective. The increase of BMI before pregnancy and during pregnancy will lead to hypertensive disorder in pregnancy (HDP) and abnormal glycolipid metabolism, as well as increase the risk of neonatal weight abnormalities and adverse pregnancy outcome. This study retrospectively analyzed the clinical data of 358 women who were admitted to the obstetrics department of our hospital from January 2018 to July 2019. And the relationship between prepregnancy BMI, BMI increase during pregnancy and delivery methods, postpartum hemorrhage, neonatal weight, premature delivery, neonatal asphyxia, gestational diabetes mellitus (GDM), and hypertension during pregnancy (HDP) was observed and compared. The results show that both high BMI before pregnancy and excessive weight gain during pregnancy can lead to the incidence of abnormal birth weight and adverse birth outcome increase. Therefore, in order to reduce the incidence of neonatal weight abnormalities and adverse birth outcomes and to prevent the adverse effects during pregnancy and postpartum, clinically, obese women should be guided to eat according to reasonable diet and exercise to control their weight.
Collapse
|