The gestational weight gain trajectories of full-term singleton pregnant women for different neonatal birth weight outcomes in Zhongshan, China: a multi-center retrospective longitudinal follow-up study

Abstract

Abstract Background Low or excess gestational weight gain (GWG) is associated with higher risk of adverse maternal and infant outcomes, and the GWG charts were different in four pre-pregnancy BMI categories, but the GWG trajectories based on different pregnant outcomes were seldom established to date.Objectives To establish a maternal GWG trajectory for each neonatal birth weight category by pre-pregnancy BMI, and analyse their associations.Methods A retrospective longitudinal follow-up study was conducted base on the real-word electronic healthcare record of prenatal visit and delivery in 28 hospitals, which included 319,926 pregnant women between January 2017 and December 2020 in Zhongshan, China. The means and percentiles of GWG by gestational week (GW) for each neonatal birth weight category were calculated and fitted by GAMLSS, and were used to establish GWG trajectories respectively.Results There were 100,691 and 136,342 full-term singleton pregnancies in final two cohorts respectively. After 15th GW to 40th GW, low birth weight (LBW) or small for gestational age (SGA) had a lower level and macrosomia or large for gestational age (LGA) had a higher level of mean GWG comparing with normal birth weight (NBW) or appropriate gestational age (AGA) (P < 0.05) at each GW. The mean and percentile charts of GWG showed that the GWG trajectories were lower in LBW/SGA and higher in macrosomia/LGA than in NBW/AGA.Conclusions Neonatal birth weight outcomes are associated with the distinctive maternal GWG trajectories, and neonatal health outcomes depend on sustenance of an appropriate GWG trajectory.