Early Nutritional Intake and Postnatal Brain Growth in Very Preterm Infants

Objectives: Prepregnancy weight change from early adulthood reflects preconception nutritional status and energy balance, potentially influencing fetal development.Yet, evidence in Asian populations remains limited.We explored the relationship between prepregnancy weight change, fetal growth, and adverse birth outcomes among women in China.Methods: This study included 6934 pregnant women from the Tongji-Huaxi-Shuangliu Birth Cohort Study.Prepregnancy weight change was defined as the difference between the weight at age 18 and weight before pregnancy.Fetal growth parameters, including head circumference (HC), biparietal diameter (BD), abdominal circumference (AC), femur length (FL), and estimated fetal weight (EFW), were assessed via ultrasound.Adverse birth outcomes, including preterm birth, low birth weight (LBW), macrosomia, small for gestational age (SGA), and large for gestational age (LGA), were obtained from medical records.Associations were estimated using linear mixed models and logistic regression models, adjusted for sociodemographic, reproductive, and lifestyle factors.Results: The mean (standard deviation [SD]) maternal age was 26.7 (3.7) years.After multivariable adjustment, each SD increase in prepregnancy weight change was associated with higher Z scores of HC (0.034 (0.012, 0.055)), BD (0.033 (0.010, 0.055)), AC (0.040 (0.020, 0.059)), FL (0.045 (0.023, 0.066)), and EFW (0.052 (0.030, 0.073)).Prepregnancy weight change was positively associated with risks of macrosomia and LGA, and inversely associated with SGA risk (all P 0.02).In contrast to women with stable weight (weight fluctuating within AE 5.0 kg), those with high weight gain (! 10.0 kg) experienced a higher risk of macrosomia (odds ratio [OR]: 1.50; 95% confidence interval [CI]: 1.05, 2.14) and LGA (OR: 1.56; 95% CI: 1.26, 1.93).No significant associations were observed between prepregnancy weight change and preterm birth or LBW.Conclusions: Excessive prepregnancy weight gain was associated with higher Z scores of fetal growth parameters and increased risks of macrosomia and LGA.Maintaining weight stability from early adulthood to pregnancy is crucial for improving neonatal health.