10.3390/polym8030084

Vollständiger Abstract

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<b>Background</b>: Thai obstetric nurses follow WHO gestational weight gain (GWG) guidelines to prevent gestational diabetes mellitus (GDM). However, these Western-derived guidelines misclassify approximately 16% of Thai pregnant women, who carry excess metabolic risk at lower BMI values than Western populations. <b>Objectives</b>: To derive and validate Thai-specific GWG targets using Thai BMI cut-points across five BMI subgroups and assess implications for nursing practice in GDM prevention. <b>Methods</b>: Retrospective cohort study of 1396 Thai singleton pregnancies at a maternal and child hospital (2023-2025). GWG targets were derived as interquartile ranges (P25-P75) from a healthy-outcomes subgroup (<i>n</i> = 706), with validity confirmed by multivariable logistic regression and a 70:30 derivation/validation split. <b>Results</b>: GDM prevalence was 15.8%, with a rising crude trend that was attenuated after accounting for a mid-study change in screening protocol. Provisional Thai-specific GWG targets were underweight/normal weight 11.5-18.0 kg, overweight 9.7-18.0 kg, obesity class I 9.1-16.0 kg, and obesity class II+ 5.8-12.1 kg. Inadequate GWG in obesity class I was associated with a 3.92-fold GDM risk increase (aOR 3.92, 95% CI 2.12-7.24, <i>p</i> < 0.001). Adherence improved from 34.7% (IOM 2009) to 50.2% with Thai-specific targets. <b>Conclusions</b>: These Thai-specific GWG targets are provisional, single-centre pilot estimates. They appear clinically safe and are substantially more achievable than IOM 2009 criteria and are offered to inform BMI-appropriate antenatal counselling and to justify a multi-centre validation study, rather than as ranges that are ready for immediate national adoption.

Abstract: PubMed · Datensatz