Associations of pre-pregnancy BMI and gestational weight gain with large-for-gestational-age in women with gestational diabetes mellitus in Southwestern China.
7 affiliations
- 1Department of Obstetrics, Obstetrics & Gynecology Hospital of Fudan University, Shanghai Key Lab of Reproduction and Development, Shanghai Key Lab of Female Reproductive Endocrine Related Diseases, Shanghai, 200433, China.
- 2Department of Nursing, Yongping County People's Hospital, Dali, Yunnan, China.
- 3Department of Emergency, Yongping County People's Hospital, Dali, Yunnan, China.
- 4Department of Obstetrics and Gynecology, Yongping County People's Hospital, Dali, Yunnan, China.
- 5Department of Obstetrics, Obstetrics & Gynecology Hospital of Fudan University, Shanghai Key Lab of Reproduction and Development, Shanghai Key Lab of Female Reproductive Endocrine Related Diseases, Shanghai, 200433, China. [email protected].
- 6Department of Obstetrics, Obstetrics & Gynecology Hospital of Fudan University, Shanghai Key Lab of Reproduction and Development, Shanghai Key Lab of Female Reproductive Endocrine Related Diseases, Shanghai, 200433, China. [email protected].
- 7Department of Neonatology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai Key Lab of Reproduction and Development, Shanghai Key Lab of Female Reproductive Endocrine Related Diseases, Shanghai, 200433, China. [email protected].
Abstract
Background
Large-for-gestational-age (LGA) infants are a common complication of gestational diabetes mellitus (GDM), increasing the risk of obstetric trauma and long-term metabolic disorders. Pre-pregnancy body mass index (ppBMI) and gestational weight gain (GWG) are modifiable maternal factors, but their joint impact on LGA in sub-high-altitude, multiethnic populations remain unclear.Objective
To examine the independent and combined associations of ppBMI and GWG with LGA risk among women with GDM in a sub-high-altitude, multiethnic region of southwestern China.Methods
In this retrospective cohort study, clinical data from 407 women with GDM, diagnosed according to the Chinese national guideline (WS 331-2011) at 24-28 weeks of gestation, were analyzed. ppBMI and GWG were categorized according to national criteria. LGA was defined using Chinese birth weight references, with sensitivity analyses applying INTERGROWTH-21st standards. Multivariable logistic regression models evaluated independent and combined associations, adjusting for maternal age, infant sex, and gestational age at delivery. Sensitivity analyses additionally accounted for maternal insulin use, parity, and gravidity.Results
Women with overweight/obese ppBMI combined with excessive GWG had the highest risk of LGA (adjusted OR 4.03, 95% CI 1.61-10.11). Excessive GWG among normal/underweight women showed a non-significant trend toward increased LGA risk (adjusted OR 2.60, 95% CI 0.95-7.14). Male infant sex was consistently associated with higher LGA odds. Findings were robust across sensitivity analyses and alternative birth weight standards.Conclusions
Elevated ppBMI combined with excessive GWG is associated with higher LGA risk in women with GDM in sub-high-altitude, multiethnic regions. These findings are exploratory and hypothesis-generating, and may inform hypotheses for future research on BMI-stratified gestational weight patterns and potential intervention strategies. Prospective studies are warranted to confirm these associations and optimize maternal and neonatal outcomes.
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- Temporal patterns and adverse pregnancy outcomes of hypertensive disorders of pregnancy and gestational diabetes mellitus in Hebei Province, China, 2017–2023: a multicenter retrospective cohort study
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BibTeX
@article{qian2026associations,
title = {{Associations of pre-pregnancy BMI and gestational weight gain with large-for-gestational-age in women with gestational diabetes mellitus in Southwestern China.}},
author = {Shuhua Qian and Jianqin Yang and Yan Tian and Qian Zhao and Rujuan Wang and Jianjie Yang and Lei Shu and Xinli Zhu and Jiahui He},
journal = {BMC pregnancy and childbirth},
year = {2026},
month = jul,
doi = {10.1186/s12884-026-09694-x},
url = {https://europepmc.org/article/MED/42907773},
note = {CC BY},
}
RIS
TY - JOUR
TI - Associations of pre-pregnancy BMI and gestational weight gain with large-for-gestational-age in women with gestational diabetes mellitus in Southwestern China.
AU - Shuhua Qian
AU - Jianqin Yang
AU - Yan Tian
AU - Qian Zhao
AU - Rujuan Wang
AU - Jianjie Yang
AU - Lei Shu
AU - Xinli Zhu
AU - Jiahui He
PY - 2026
DA - 2026/07/01
JO - BMC pregnancy and childbirth
DO - 10.1186/s12884-026-09694-x
UR - https://europepmc.org/article/MED/42907773
AB - Background Large-for-gestational-age (LGA) infants are a common complication of gestational diabetes mellitus (GDM), increasing the risk of obstetric trauma and long-term metabolic disorders. Pre-pregnancy body mass index (ppBMI) and gestational weight gain (GWG) are modifiable maternal factors, but their joint impact on LGA in sub-high-altitude, multiethnic populations remain unclear.Objective To examine the independent and combined associations of ppBMI and GWG with LGA risk among women with GDM in a sub-high-altitude, multiethnic region of southwestern China.Methods In this retrospective cohort study, clinical data from 407 women with GDM, diagnosed according to the Chinese national guideline (WS 331-2011) at 24-28 weeks of gestation, were analyzed. ppBMI and GWG were categorized according to national criteria. LGA was defined using Chinese birth weight references, with sensitivity analyses applying INTERGROWTH-21st standards. Multivariable logistic regression models evaluated independent and combined associations, adjusting for maternal age, infant sex, and gestational age at delivery. Sensitivity analyses additionally accounted for maternal insulin use, parity, and gravidity.Results Women with overweight/obese ppBMI combined with excessive GWG had the highest risk of LGA (adjusted OR 4.03, 95% CI 1.61-10.11). Excessive GWG among normal/underweight women showed a non-significant trend toward increased LGA risk (adjusted OR 2.60, 95% CI 0.95-7.14). Male infant sex was consistently associated with higher LGA odds. Findings were robust across sensitivity analyses and alternative birth weight standards.Conclusions Elevated ppBMI combined with excessive GWG is associated with higher LGA risk in women with GDM in sub-high-altitude, multiethnic regions. These findings are exploratory and hypothesis-generating, and may inform hypotheses for future research on BMI-stratified gestational weight patterns and potential intervention strategies. Prospective studies are warranted to confirm these associations and optimize maternal and neonatal outcomes.
SN - 1471-2393
ER -