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Introduction Previous studies have demonstrated that abnormal body mass index (BMI) is associated with adverse pregnancy outcomes in frozen–thawed embryo transfer cycles. However, the relationship between BMI and pregnancy and perinatal outcomes in patients with polycystic ovary syndrome (PCOS) remains unclear. Furthermore, whether a diagnosis of PCOS could result in adverse pregnancy and perinatal outcomes in women with different BMIs remains unknown. Material and methods A historical cohort study included 1667 women with PCOS and 12 256 women without PCOS after a freeze‐all policy between January 2016 and December 2020. The outcomes encompassed both pregnancy and perinatal outcomes. Multivariate logistic regression analysis and restricted cubic spline models were performed to eliminate confounding factors when investigating the relationship between BMI and different outcomes. Results After controlling for covariates, pregnancy outcomes were comparable between underweight women with PCOS and normal weight women with PCOS. However, overweight patients had a lower clinical pregnancy rate and an overall live birth rate. Furthermore, patients with obesity had a lower rate of multiple pregnancies but a higher rate of biochemical pregnancy than in the normal BMI group. Additionally, the restricted cubic spline models showed that as maternal BMI increased to 32 kg/m2, the clinical pregnancy rate and live birth rate after blastocyst transfer decreased, but the risks of preterm birth, gestational diabetes mellitus, macrosomia, large‐for‐gestational age (LGA) and very LGA increased in patients with PCOS after a freeze‐all strategy. Moreover, a diagnosis of PCOS resulted in a higher clinical pregnancy rate and live birth rate and a higher risk of small‐for‐gestational age in the normal weight group. However, women with PCOS in the overweight group exhibited higher risks of very preterm birth and gestational diabetes mellitus compared with women without PCOS. Conclusions This study showed that a higher BMI had a detrimental impact on the pregnancy and perinatal outcomes of PCOS patients undergoing a freeze‐all strategy. However, it was only statistically significant in the overweight group. A diagnosis of PCOS had a higher clinical pregnancy rate and live birth rate in normal weight women but higher risks of perinatal complications in normal weight and overweight women. This study focused on women diagnosed with PCOS who had all their embryos frozen and underwent the first FET cycles. An increased BMI resulted in adverse reproductive outcomes. Weight management is of great importance for all women, irrespective of the PCOS state.

Background The potential effects of pre-pregnancy body mass (BMI) and gestational weight gain (GWG) on pregnancy outcomes remain unclear. Thus, we investigated socio-demographic characteristics that affect pre-pregnancy BMIs and GWG and the effects of pre-pregnancy BMI and GWG on Chinese maternal and infant complications. Methods 3172 women were enrolled in the Chinese Pregnant Women Cohort Study-Peking Union Medical College from July 25, 2017 to July 24, 2018, whose babies were delivered before December 31, 2018. Regression analysis was employed to evaluate the socio-demographic characteristics affecting pre-pregnancy BMI and GWG values and their effects on adverse maternal and infant complications. Results Multivariate logistic regression analysis revealed that age groups < 20 years (OR: 1.97), 25–30 years (OR: 1.66), 30–35 years (OR: 2.24), 35–40 years (OR: 3.90) and ≥ 40 years (OR: 3.33) as well as elementary school or education below (OR: 3.53), middle school (OR: 1.53), high school (OR: 1.40), and living in the north (OR: 1.37) were risk factors in maintaining a normal pre-pregnancy BMI. An age range of 30–35 years (OR: 0.76), living in the north (OR: 1.32) and race of ethnic minorities (OR: 1.51) were factors affecting GWG. Overweight (OR: 2.01) and inadequate GWG (OR: 1.60) were risk factors for gestational diabetes mellitus (GDM). Overweight (OR: 2.80) and obesity (OR: 5.42) were risk factors for gestational hypertension (GHp). Overweight (OR: 1.92), obesity (OR: 2.48) and excessive GWG (OR: 1.95) were risk factors for macrosomia. Overweight and excessive GWG were risk factors for a large gestational age (LGA) and inadequate GWG was a risk factor for low birth weights. Conclusions Overweight and obesity before pregnancy and an excessive GWG are associated with a greater risk of developing GDM, GHp, macrosomia and LGA. The control of body weight before and during the course of pregnancy is recommended to decrease adverse pregnancy outcomes, especially in pregnant women aged < 20 or > 25 years old educated below university and college levels, for ethnic minorities and those women who live in the north of China. Trial registration Registered at Clinical Trials ( NCT03403543 ), September 29, 2017.

Aims/hypothesisAccumulating evidence suggests an impact of gestational weight gain (GWG) on pregnancy outcomes; however, data on cardiometabolic risk factors later in life have not been comprehensively studied. This study aimed to evaluate the relationship between GWG and cardiometabolic risk in offspring aged 7 years.MethodsWe included a total of 905 mother–child pairs who enrolled in the follow-up visit of the multicentre Hyperglycemia and Adverse Pregnancy Outcome study, at the Hong Kong Centre. Women were classified as having gained weight below, within or exceeding the 2009 Institute of Medicine (IOM) guidelines. A standardised GWG according to pre-pregnancy BMI categories was calculated to explore for any quadratic relationship.ResultsIndependent of pre-pregnancy BMI, gestational hyperglycaemia and other confounders, women who gained more weight than the IOM recommendations had offspring with a larger body size and increased odds of adiposity, hypertension and insulin resistance (range of p values of all the traits: 4.6 × 10−9 < p < 0.0390) than women who were within the recommended range of weight gain during pregnancy. Meanwhile, women who gained less weight than outlined in the recommendations had offspring with increased risks of hypertension and insulin resistance, compared with those who gained weight within the recommended range (7.9 × 10−3 < p < 0.0477). Quadratic relationships for diastolic blood pressure, AUC for insulin, pancreatic beta cell function and insulin sensitivity index were confirmed in the analysis of standardised GWG (1.4 × 10−3 < pquadratic < 0.0282). Further adjustment for current BMI noticeably attenuated the observed associations.Conclusions/interpretationBoth excessive and inadequate GWG have independent and significant impacts on childhood adiposity, hypertension and insulin resistance. Our findings support the notion that adverse intrauterine exposures are associated with persistent cardiometabolic risk in the offspring.

There were limited analyses on relationship between body mass index (BMI) pre-pregnancy, as well as birth weight. Research aimed to examine the relation between these two, as well as low birth weight (LBW) risk in Jiangxi Province, China. A total of 1193 pregnant subjects from Jiangxi Province, China were enrolled in the final analysis. Standardized questionnaires were administered to the women during childbirth, newborns’ medical information was obtained from hospital records. Pre-pregnancy BMI was categorized into underweight, normal, overweight, and obese groups. Multivariate linear regression models were employed to assess connection between pre-pregnancy BMI, birth weight. We utilized generalized additive model and fitted smoothing curve (penalized spline method) to examine relationship between pre-pregnancy BMI and birth weight, as well as LBW risk. The incidence of LBW was 12.1%, with average pre-pregnancy BMI of 20.9 ± 2.5 kg/m 2 . The smoothing curve revealed an L-shaped association between pre-pregnancy BMI, birth weight and LBW risk. The curve indicated that as pre-pregnancy BMI increased, LBW risk initially decreased and then plateaued, while birth weight initially escalated and then plateaued. The inflection point for pre-pregnancy BMI was identified as 22 kg/m 2 . On the left side of inflection point, β (95% CI) for birth weight was 0.04 (0.02, 0.07), and ORs (95% CIs) for LBW risk were 0.78 (0.69, 0.89), on the right side the corresponding values were − 0.00 (-0.03, 0.03) and 1.02 (0.88, 1.19), respectively. All the outcomes presented to be similar in various subgroups. Within a specific range (BMI<22 kg/m 2 ), the correlation between pre-pregnancy BMI and birth weight is statistically significant. This research indicated pre-pregnancy BMI demonstrates a saturation effect on birth weight and LBW risk among Jiangxi Province population.

To investigate the association between maternal pre-pregnancy body mass index (BMI) and astigmatism and corneal curvature in offspring. Corneal topography and an optical biometer were used to measure ocular parameters, while cycloplegic autorefraction was performed to assess cylindrical diopter and axis. Demographic, pregnancy, and offspring-related information was collected through questionnaires. Multiple linear regression analyses were conducted to evaluate the association. A total of 213 mother-child pairs were included. Maternal pre-pregnancy BMI was categorized as underweight (11.3%), normal weight (66.7%), overweight (16.0%), and obese (6.1%). The mean age of the offspring was 6.80 ± 2.44 years (males 49.3%). Offspring born to mothers with overweight or obese pre-pregnancy BMI exhibited significantly higher steep corneal curvature, average corneal curvature, corneal astigmatism, and total astigmatism compared to those in the normal pre-pregnancy BMI group. In multiple linear regression analysis, after adjusting for relevant covariates, pre-pregnancy BMI was positively associated with steep corneal curvature (β=0.35, P=0.005), corneal astigmatism (β=0.21, P=0.001), and total astigmatism (β=0.22, P<0.001). Compared to normal pre-pregnancy BMI, pre-pregnancy obesity was positively associated with offspring steep corneal curvature (β=1.52, P=0.002) and those born to mothers with overweight or obese pre-pregnancy BMI had a significantly higher prevalence of corneal astigmatism (overweight: β=0.56, P=0.001; obese: β=0.55, P=0.038) and total astigmatism (overweight: β=0.47, P=0.002; obese: β=0.59, P=0.010). Offspring of mothers with overweight or obese pre-pregnancy BMI show higher prevalence of developing corneal and total astigmatism compared to the normal.

Investigating the association between gestational weight gain (GWG) on low birth weight (LBW, birth weight < 2500 g) across pre‐pregnancy body mass index (BMI) categories (underweight: < 18.5, normal: 18.5–24.9 and overweight/obese: ≥ 25 kg/m²) is crucial for clinical practice. While the Institute of Medicine's (IOM) 2009 GWG guidelines are widely used, evidence‐based data from diverse populations is scarce, creating a global research gap. We explored how total GWG and adherence to IOM recommendations affected the odds of LBW across BMI categories in the Sri Lankan context. This nationwide prospective study evaluated 1499 maternal and singleton‐newborn pairs between August 2022 and April 2024. Unadjusted and adjusted logistic regression analyses were performed. An increase in total GWG z‐score was associated with decreased odds of LBW among women with underweight pre‐pregnancy BMI (aOR: 0.56, 95% CI: 0.35‒0.89), but no significant association was observed among women with normal or ≥ 25 kg/m² BMI. Women with underweight BMI whose GWG was below the IOM recommended range showed higher odds of LBW than those with GWG within the recommended range (aOR 3.05, 95% CI: 1.08‒8.61). However, among women with normal or higher BMI, GWG below the recommended range was not significantly associated with LBW. These findings suggest that the association between GWG and odds of LBW varies across pre‐pregnancy BMI categories. Among Sri Lankan women with underweight pre‐pregnancy BMI, gaining pregnancy weight within the IOM GWG recommendations was associated with significantly lower odds of delivering an LBW newborn. This association was not observed among women with normal or higher BMI. Gestational weight gain below the Institute of Medicine's recommended range was most prevalent among Sri Lankan women with underweight pre‐pregnancy body mass index and was associated with higher odds of low birth weight deliveries. Summary The impact of the Institute of Medicine's gestational weight gain recommendations on adverse birth outcomes in Asian populations is unclear and lacks evidence‐based findings. Pre‐pregnancy body mass index and gestational weight gain impact newborns' birth weight. Gaining pregnancy weight within the IOM‐recommended range was associated with reduced odds of LBW among Sri Lankan women with underweight pre‐pregnancy BMI, whereas no such association was observed among women in other BMI categories.

Objective: To investigate whether delivery mode (vaginal versus by caesarean section), maternal pre-pregnancy body mass index (BMI) and early exposure to antibiotics (<6 months of age) influence child's risk of overweight at age 7 years, hence supporting the hypotheses that environmental factors influencing the establishment and diversity of the gut microbiota are associated with later risk of overweight. Design: Longitudinal, prospective study with measure of exposures in infancy and follow-up at age 7 years. Methods: A total of 28 354 mother–child dyads from the Danish National Birth Cohort, with information on maternal pre-pregnancy BMI, delivery mode and antibiotic administration in infancy, were assessed. Logistic regression analyses were performed with childhood height and weight at the 7-year follow-up as outcome measures. Results: Delivery mode was not significantly associated with childhood overweight (odds ratio (OR):1.18, 95% confidence interval (CI): 0.95–1.47). Antibiotics during the first 6 months of life led to increased risk of overweight among children of normal weight mothers (OR: 1.54, 95% CI: 1.09–2.17) and a decreased risk of overweight among children of overweight mothers (OR: 0.54, 95% CI: 0.30–0.98). The same tendency was observed among children of obese mothers (OR: 0.85, 95% CI: 0.41–1.76). Conclusion: The present cohort study revealed that a combination of early exposures, including delivery mode, maternal pre-pregnancy BMI and antibiotics in infancy, influences the risk of overweight in later childhood. This effect may potentially be explained by an impact on establishment and diversity of the microbiota.

Maternal overweight/obesity has been associated with an increased risk of obesity in childhood. We investigated the effect of maternal overweight/obesity during pre-pregnancy and whether it is a stronger predictor of child obesity, compared to maternal overweight/obesity during childhood. Prospective or retrospective cohort studies published in English, reporting on obese children and adolescents (2–18 years), with overweight/obese mothers in either pre-pregnancy or during childhood were included. A search was conducted from 2012 to April 2022 in MEDLINE, Web of Science, CINAHL, and EMBASE, followed by screening, data extraction, quality assessment and narrative synthesis. Eleven eligible studies (9 prospective and 2 retrospective cohort studies; total sample, n = 27,505) were identified. Eight studies examined maternal overweight/obesity in pre-conception, presenting consistent positive associations with childhood obesity, three reported positive associations between childhood obesity and maternal overweight/obesity during childhood, and one presented positive associations between both maternal exposures. The narrative synthesis failed to identify which maternal exposure is the strongest predictor of childhood obesity, with studies reporting significant associations between maternal overweight/obesity and child obesity in both time points. Intervention programs aiming to reduce childhood obesity should focus on supporting women of childbearing age with weight management from preconception and throughout their life-course.

The nutrient composition of breast milk alters during lactation, and maternal BMI adds more intricacy into its complexity. We aimed to compare leptin, ghrelin, adiponectin and insulin-like growth factor-1 (IGF-1) levels of pre-feed and post-feed breast milk in mothers with obesity and normal weight, and tried to determine their effects on infants’ growth over weight for length z-score. Twenty obese and twenty normal weight mothers with 2-month-old infants were enrolled in this case–control study. Five millilitre pre-feed breast milk and 5 ml post-feed breast milk were collected. Breast milk leptin, ghrelin, adiponectin and IGF-1 were measured by commercial kits. The pre-feed breast milk of mothers with obesity had significantly higher levels of ghrelin than mothers with normal weight (P = 0·025), whereas the post-feed breast milk of mothers with normal weight had higher levels of adiponectin than the mothers with obesity (P = 0·010). No significant differences were observed in leptin and IGF-1 levels between the two groups. Post-feed breast milk IGF-1 levels of mothers with obesity were correlated with infant’s weight for length z-score at 2 months (r −0·476; P = 0·034). In linear regression models, parity affected the ghrelin in pre-feed breast milk (P = 0·025). Our results revealed that maternal pre-pregnancy BMI was associated with breast milk components.

Background Pre-pregnancy BMI (PP BMI) and gestational weight gain (GWG) are prominent anthropometric indicators for maternal nutritional status and are related to an increased risk of adverse pregnancy outcomes. This study aimed to determine the factors affecting total GWG, PP BMI and pregnancy outcomes among pregnant women in West Sumatra, Indonesia. Methods This observational analysis was conducted among healthy women in the Vitamin D Pregnant Mother (VDPM) cohort study. A total of 195 pregnant women and their newborn babies were enrolled, and information regarding their socio-demographic characteristics, obstetric history, dietary intake and anthropometric data were assessed through direct interviews. Furthermore, the Institute of Medicine (IOM) 2009 guidelines were used to obtain the total GWG. Results PP BMI was used to categorise the 195 pregnant women as overweight/obese (43.1%), normal (46.7%) and underweight (10.2%). There were 53.3%, 34.4% and 12.3% of women who had inadequate, adequate and excessive GWG, respectively. The multinomial logistic regression model indicated that overweight or obese women at the pre-pregnancy stage were 4.09 times more likely to have an excessive rate of GWG (AOR = 4.09, 95% CI: 1.38–12.12, p  = 0.011) than those whose weight was normal. Furthermore, women with excessive GWG were 27.11 times more likely to have a baby with macrosomia (AOR = 27.11, 95% CI: 2.99–245.14) ( p  = 0.001) and those with inadequate GWG were 9.6 times more likely to give birth to a baby with low birth weight (LBW) (AOR = 9.60, 95% CI; 0.88–105.2) ( p  = 0.002). Conclusions This study demonstrates that the malnutrition status prior to pregnancy and inadequate or excessive GWG status during pregnancy as significant risk factors for developing adverse pregnancy outcomes. These findings highlight the importance of providing information, preconception counselling and health education on weight management for healthy pregnancies.