Combination of Body Mass Index and Body Fat Percentage in Middle and Late Pregnancy to Predict Pregnancy Outcomes in Patients with Gestational Diabetes in Wenzhou, China: a Single-centre Retrospective Cohort Study

Overview

Journal BMJ Open

Specialty General Medicine

Date 2024 Nov 9

PMID 39521470

Authors

Bingru Chen

Lanxi Chen

Xiner Zhao

Tao You

Zhi Zheng

Yilin Chen

Shuoru Zhu

Affiliations

Soon will be listed here.

Abstract

Objectives: The present study aimed to evaluate whether body mass index (BMI) and body fat percentage (BFP) could be used to predict pregnancy outcomes in patients with gestational diabetes mellitus (GDM).

Design: Retrospective cohort study.

Setting: Wenzhou Medical University Affiliated Second Hospital (Zhejiang Province, China). Clinical data were collected from electronic medical records.

Participants: Data from 683 patients with GDM admitted to the Wenzhou Medical University Affiliated Second Hospital between January 2019 and December 2021 were retrospectively analysed.

Outcome Measures: Pregnancy outcomes.

Results: The results showed that pregnant women with BFP ≥33% were more prone to abnormal amniotic fluid volume, abnormal blood pressure and anaemia (p<0.05). Additionally, these patients were more likely to experience postpartum haemorrhage and macrosomia, as well as risk factors associated with caesarean section at labour (p<0.05). BMI exhibited a strong predictive value for abnormal blood pressure (OR 1.170; 95% CI 1.090 to 1.275), anaemia (OR 1.073; 95% CI 1.016 to 1.134), caesarean section (OR 1.150; 95% CI 1.096 to 1.208) and macrosomia (OR 1.169; 95% CI 1.063 to 1.285). Additionally, classified BFP had a predictive value for abnormal amniotic fluid volume (OR 3.196; 95% CI 1.294 to 7.894), abnormal blood pressure (OR 2.321; 95% CI 1.186 to 4.545), anaemia (OR 1.817; 95% CI 1.216 to 2.714), and caesarean section (OR 1.734; 95% CI 1.270 to 2.367).

Conclusions: The results suggest that patients with GDM with BFP ≥33% were more likely to experience unfavourable pregnancy outcomes, undergo caesarean section and develop macrosomia. The combination of BMI with classified BFP could better predict abnormal blood pressure and caesarean section in patients with GDM during the middle and late stages of pregnancy.

References

Chu S, Callaghan W, Kim S, Schmid C, Lau J, England L . Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care. 2007; 30(8):2070-6. DOI: 10.2337/dc06-2559a. View

Bosy-Westphal A, Later W, Hitze B, Sato T, Kossel E, Gluer C . Accuracy of bioelectrical impedance consumer devices for measurement of body composition in comparison to whole body magnetic resonance imaging and dual X-ray absorptiometry. Obes Facts. 2010; 1(6):319-24. PMC: 6452160. DOI: 10.1159/000176061. View

Liu Y, Li G, Zhang W . Effect of fetal gender on pregnancy outcomes in Northern China. J Matern Fetal Neonatal Med. 2016; 30(7):858-863. DOI: 10.1080/14767058.2016.1189527. View

Liu Y, Liu J, Gao Y, Zheng D, Pan W, Nie M . The Body Composition in Early Pregnancy is Associated with the Risk of Development of Gestational Diabetes Mellitus Late During the Second Trimester. Diabetes Metab Syndr Obes. 2020; 13:2367-2374. PMC: 7352009. DOI: 10.2147/DMSO.S245155. View

Widen E, Gallagher D . Body composition changes in pregnancy: measurement, predictors and outcomes. Eur J Clin Nutr. 2014; 68(6):643-52. PMC: 4078736. DOI: 10.1038/ejcn.2014.40. View

Zhao P, Bedrick B, Brown K, McCarthy R, Chubiz J, Ju Y . Sleep behavior and chronotype before and throughout pregnancy. Sleep Med. 2022; 94:54-62. DOI: 10.1016/j.sleep.2022.04.002. View

Bai M, Susic D, OSullivan A, Henry A . Reproducibility of Bioelectrical Impedance Analysis in Pregnancy and the Association of Body Composition with the Risk of Gestational Diabetes: A Substudy of MUMS Cohort. J Obes. 2020; 2020:3128767. PMC: 7528004. DOI: 10.1155/2020/3128767. View

Hu J, Wang Z, Lei B, Li J, Wang R . Effects of a Low-Carbohydrate High-Fat Diet Combined with High-Intensity Interval Training on Body Composition and Maximal Oxygen Uptake: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2021; 18(20). PMC: 8535842. DOI: 10.3390/ijerph182010740. View

Piuri G, Ferrazzi E, Bulfoni C, Mastricci L, Di Martino D, Speciani A . Longitudinal changes and correlations of bioimpedance and anthropometric measurements in pregnancy: Simple possible bed-side tools to assess pregnancy evolution. J Matern Fetal Neonatal Med. 2016; 30(23):2824-2830. DOI: 10.1080/14767058.2016.1265929. View

10.

Koike S, Hardy R, Richards M . Adolescent self-control behavior predicts body weight through the life course: a prospective birth cohort study. Int J Obes (Lond). 2015; 40(1):71-6. PMC: 4704138. DOI: 10.1038/ijo.2015.213. View

11.

Chen M, Liu J, Ma Y, Li Y, Gao D, Chen L . Association between Body Fat and Elevated Blood Pressure among Children and Adolescents Aged 7-17 Years: Using Dual-Energy X-ray Absorptiometry (DEXA) and Bioelectrical Impedance Analysis (BIA) from a Cross-Sectional Study in China. Int J Environ Res Public Health. 2021; 18(17). PMC: 8431661. DOI: 10.3390/ijerph18179254. View

12.

Zhao Y, Li Q, Li Y . Effects of body mass index and body fat percentage on gestational complications and outcomes. J Obstet Gynaecol Res. 2014; 40(3):705-10. DOI: 10.1111/jog.12240. View

13.

Dornelles V, Hentschke M, Badalotti M, Badalotti-Teloken I, Trindade V, Cunegatto B . Influence of overweight and obesity on perinatal outcomes in assisted reproduction: a retrospective cohort study. BMC Pregnancy Childbirth. 2022; 22(1):603. PMC: 9331091. DOI: 10.1186/s12884-022-04920-8. View

14.

Zhao R, Xu L, Wu M, Huang S, Cao X . Maternal pre-pregnancy body mass index, gestational weight gain influence birth weight. Women Birth. 2017; 31(1):e20-e25. DOI: 10.1016/j.wombi.2017.06.003. View

15.

Crozier S, Inskip H, Godfrey K, Cooper C, Harvey N, Cole Z . Weight gain in pregnancy and childhood body composition: findings from the Southampton Women's Survey. Am J Clin Nutr. 2010; 91(6):1745-51. PMC: 3091013. DOI: 10.3945/ajcn.2009.29128. View

16.

Yuen L, Wong V, Simmons D . Ethnic Disparities in Gestational Diabetes. Curr Diab Rep. 2018; 18(9):68. DOI: 10.1007/s11892-018-1040-2. View

17.

van Lee L, Crozier S, Aris I, Tint M, Sadananthan S, Michael N . Prospective associations of maternal choline status with offspring body composition in the first 5 years of life in two large mother-offspring cohorts: the Southampton Women's Survey cohort and the Growing Up in Singapore Towards healthy Outcomes.... Int J Epidemiol. 2019; 48(2):433-444. PMC: 6751083. DOI: 10.1093/ije/dyy291. View

18.

Moon J, Jang H . Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications. Diabetes Metab J. 2022; 46(1):3-14. PMC: 8831816. DOI: 10.4093/dmj.2021.0335. View

19.

Kawanabe S, Nagai Y, Nakamura Y, Nishine A, Nakagawa T, Tanaka Y . Association of the muscle/fat mass ratio with insulin resistance in gestational diabetes mellitus. Endocr J. 2018; 66(1):75-80. DOI: 10.1507/endocrj.EJ18-0252. View

20.

Lof M, Forsum E . Evaluation of bioimpedance spectroscopy for measurements of body water distribution in healthy women before, during, and after pregnancy. J Appl Physiol (1985). 2003; 96(3):967-73. DOI: 10.1152/japplphysiol.00900.2003. View