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Comparative Study Between IOM Versus Taiwan's Optimal Gestational Weight Gain Criteria And The Risk Of Adverse Birth Outcomes
Other Title
Comparative Study Between IOM Versus Taiwan's Optimal Gestational Weight Gain Criteria And The Risk Of Adverse Birth Outcomes
Type
thesis
Date Issued
5/13/25
Author(s)
Huynh Thanh Sang
Advisor
白其卉
Subjects
系所名稱：公共衛生學系碩士班
Publisher
公共衛生學系碩士班
Description
學位別：碩士
口試委員：羅偉成; 蔡秀純; 白其卉
關鍵字：Gestational weight gain、adverse birth outcomes、prepregnancy BMI
口試委員：羅偉成; 蔡秀純; 白其卉
關鍵字：Gestational weight gain、adverse birth outcomes、prepregnancy BMI
Abstract
Background: Understanding the effects of gestational weight gain (GWG) guidelines on adverse birth outcomes is critical for evidence-based maternal care, particularly given the unique characteristics of the Taiwanese population.
Objectives: This study investigates the impact of GWG on adverse birth outcomes among pregnant women in Taiwan, comparing Asian-based GWG criteria (ABC) derived from a retrospective cohort study of Taiwanese pregnant women with the Institute of Medicine (IOM) guidelines.
Methods: This population-based prospective cohort study analyzed data from 1,024 Taiwanese pregnant women from the nationwide Nutrition and Health Survey in Taiwanese Pregnant Women (NAHSIT-P, 2017–2019). GWG was categorized based on the criterion from a previous study into below, within, and above. Adverse birth outcomes, including small for gestational age, preterm birth, low birth weight, and cesarean section, were assessed using modified Poisson regression, adjusted for demographic, nutritional, and medical factors. Dietary intake was assessed via a food frequency questionnaire and a 24-hour recall. Anemia biomarkers were measured from blood samples. The predictive performance of models was evaluated using the Receiver Operating Characteristic curves analysis. A sensitivity analysis compared the ABC and IOM’s guidelines.
Results: Under Asian-based criteria, women with below-recommended GWG had an increased preterm birth risk (aRR = 1.66, 95% CI: 1.02–2.70), while no significant association was observed under IOM’s guidelines. For low birth weight, women in the above GWG group per Asian-based criteria showed reduced risk (aRR = 0.38, 95% CI: 0.18–0.82), while those in the below GWG group under IOM’s guidelines had increased risk (aRR = 2.03, 95% CI: 1.16–3.55). Excessive GWG was associated with higher cesarean section risk across both guidelines, with an aRR of 1.48 (95% CI: 1.11–1.96) under ABC and 1.37 (95% CI: 1.00–1.88) under IOM.
Conclusions: Asian-based GWG criteria effectively predict adverse birth outcomes. Excessive GWG was associated with an increased risk of cesarean section and a decreased risk of low birth weight, while insufficient GWG was linked to a higher risk of preterm birth. These findings highlight the importance of comprehensive prenatal care, including dietary management and regular GWG monitoring, to improve maternal and neonatal health outcomes.
Declaration: This work was funded by the Health Promotion Administration, Ministry of Health and Welfare. The content of this research may not represent the opinion of the Health Promotion Administration, Ministry of Health and Welfare (MOHW113-HPA-H-114-114404).
Objectives: This study investigates the impact of GWG on adverse birth outcomes among pregnant women in Taiwan, comparing Asian-based GWG criteria (ABC) derived from a retrospective cohort study of Taiwanese pregnant women with the Institute of Medicine (IOM) guidelines.
Methods: This population-based prospective cohort study analyzed data from 1,024 Taiwanese pregnant women from the nationwide Nutrition and Health Survey in Taiwanese Pregnant Women (NAHSIT-P, 2017–2019). GWG was categorized based on the criterion from a previous study into below, within, and above. Adverse birth outcomes, including small for gestational age, preterm birth, low birth weight, and cesarean section, were assessed using modified Poisson regression, adjusted for demographic, nutritional, and medical factors. Dietary intake was assessed via a food frequency questionnaire and a 24-hour recall. Anemia biomarkers were measured from blood samples. The predictive performance of models was evaluated using the Receiver Operating Characteristic curves analysis. A sensitivity analysis compared the ABC and IOM’s guidelines.
Results: Under Asian-based criteria, women with below-recommended GWG had an increased preterm birth risk (aRR = 1.66, 95% CI: 1.02–2.70), while no significant association was observed under IOM’s guidelines. For low birth weight, women in the above GWG group per Asian-based criteria showed reduced risk (aRR = 0.38, 95% CI: 0.18–0.82), while those in the below GWG group under IOM’s guidelines had increased risk (aRR = 2.03, 95% CI: 1.16–3.55). Excessive GWG was associated with higher cesarean section risk across both guidelines, with an aRR of 1.48 (95% CI: 1.11–1.96) under ABC and 1.37 (95% CI: 1.00–1.88) under IOM.
Conclusions: Asian-based GWG criteria effectively predict adverse birth outcomes. Excessive GWG was associated with an increased risk of cesarean section and a decreased risk of low birth weight, while insufficient GWG was linked to a higher risk of preterm birth. These findings highlight the importance of comprehensive prenatal care, including dietary management and regular GWG monitoring, to improve maternal and neonatal health outcomes.
Declaration: This work was funded by the Health Promotion Administration, Ministry of Health and Welfare. The content of this research may not represent the opinion of the Health Promotion Administration, Ministry of Health and Welfare (MOHW113-HPA-H-114-114404).