Overweight, Gestational Weight Gain and Elevated Fasting Plasma Glucose and Their Association with Macrosomia in Chinese Pregnant Women

To provide a current estimation of overweight, gestational weight gain(GWG), elevated fasting plasma glucose (FPG) in pregnant women in Kunshan, China and investigate their association with macrosomia using recommendations of IOM and International Association of Diabetes and Pregnancy Study Groups. We conducted a population-based retrospective study and analyzed routine data from Kunshan Maternity and Child Care Surveillance System of 27,322 women with singleton full-term birth from 2006 to 2010. The prevalence of maternal overweight at early pregnancy according to WHO BMI categories (BMI: 25.0–29.9 kg/m2) or the cutoffs for Chinese (BMI:24.0–27.9 kg/m2), elevated FPG (≥5.1 mmol/L) were estimated. Proportions of women with GWG below, within and above 2009 IOM recommendations were used to evaluate the adequacy of GWG. The association between maternal overweight, GWG, elevated FPG and macrosomia was analyzed by multiple logistic regression. The prevalence of maternal overweight was 8.9 % according to WHO BMI categories and 11.9 % according to Chinese cutoffs. The rate of elevated FPG at first prenatal visit was 19.4 %. Overweight women gained, on average, 12.2 ± 5.3 or 13.0 ± 5.2 (kg) during gestation, 57.1 or 63.93 % of which had excessive weight gain above IOM recommendations (6.8–11.4 kg) according to WHO BMI categories or Chinese cutoffs, respectively. Maternal overweight, GWG and elevated FPG were positively and significantly associated with macrosomia after adjusting for maternal age and gestational weeks at delivery. Maternal overweight, excessive weight gain, elevated FPG are common in the Chinese population in Kunshan. These metabolic risk factors associated with macrosomia should be controlled under the recommendations for Chinese pregnant population.