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Associations of early-pregnancy BMI and body fat percentage with macrosomia under the updated international obesity definition: a birth cohort study
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Yuge ZHANG1, Lu WANG2, 3, Lanling WANG3, 4, Jinlang LYU2, 3, Zhanbo SUN3, 4, Yuelong JI2, 3, Shusheng LUO2, 3, Jue LIU3, 5, Guojie LIU3, 4, Haijun WANG2, 3
Chinese Journal of Public Health | 2026, 42(7) : 769 - 774
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Chinese Journal of Public Health | 2026, 42(7): 769-774
• Special Report—Healthy Weight Management Initiative •
Associations of early-pregnancy BMI and body fat percentage with macrosomia under the updated international obesity definition: a birth cohort study
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Yuge ZHANG1, Lu WANG2, 3, Lanling WANG3, 4, Jinlang LYU2, 3, Zhanbo SUN3, 4, Yuelong JI2, 3, Shusheng LUO2, 3, Jue LIU3, 5, Guojie LIU3, 4, Haijun WANG2, 3
Affiliations
  • 1School of Public Health, Shandong Second Medical University, Weifang 261053, China
  • 2Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China
  • 3Peking University Health Science Center-Weifang Joint Research Center for Maternal and Child Health, Beijing 100191, China
  • 4Weifang Maternal and Child Health Hospital, Weifang 261021, China
  • 5Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Published: 2026-07-10 doi: 10.11847/zgggws1148746
Outline
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Objective

To analyze the associations of early-pregnancy body mass index (BMI), body fat percentage, and comprehensive indexes with the risk of macrosomia under the updated international obesity definition.

Methods

The study was part of the Peking University-Weifang Birth Cohort. Between March 2024 and February 2025, 650 pregnant women who had registered, undergone physical examinations during early pregnancy (6 weeks to 13 weeks and 6 days of gestation), and subsequently delivered before August 1, 2025 at Weifang Maternal and Child Health Hospital were recruited. Researchers collected basic demographic information and calculated BMI based on on-site measurements of body height and body weight during early pregnancy. Body fat percentage was assessed via bioelectrical impedance analysis (BIA) and delivery data, including gestational age, fetal sex, and birth weight, were obtained during childbirth. The obesity of mothers in early pregnancy was determined by three methods: BMI, body fat percentage, and new international definition of obesity, and the association between obesity in early pregnancy and macrosomia was analyzed by multivariate logistic regression and trend test.

Results

Among the 650 participants, 26.31% were overweight and 14.00% were obese according to BMI criteria, and 66.46% had excessive body fat. The incidence of macrosomia was 8.62%. Compared with normal BMI, overweight did not have a significant association with macrosomia (P = 0.079), whereas obese pregnant women had a 4.155-fold increased risk of delivering macrosomic infants (OR = 5.155, 95%CI: 2.451–10.843). Compared with women with normal body fat percentage, those with excessive body fat had a 1.546-fold increased risk of delivering macrosomic infants (OR = 2.546, 95%CI: 1.243–5.215). Compared with the pregnant women with both normal BMI and normal body fat, those with BMI indicating overweight combined with excessive body fat had a 1.318-fold increased risk (OR = 2.318, 95%CI: 1.006–5.338), and those with BMI indicating obesity combined with excessive body fat had a 5.437-fold increased risk (OR = 6.437, 95%CI: 2.670–15.516). An increasing trend in the risk of macrosomia with increases in early-pregnancy BMI and body fat percentage was identified (P < 0.05).

Conclusions

According to the new international definition of obesity that combines BMI and body fat percentage, our analysis shows a strong association between obesity in early pregnancy and macrosomia. This finding supports early prevention strategies targeting pregnant women with BMI indicating normal weight or overweight and excessive body fat.

body mass index  /  body fat percentage  /  macrosomia  /  cohort  /  association  /  early pregnancy
张钰格, 王璐, 王兰玲, 吕瑾莨, 孙占波, 计岳龙, 罗树生, 刘珏, 刘国杰, 王海俊. 应用国际肥胖新定义分析孕早期BMI、体脂率与巨大儿的关联:一项出生队列研究. 中国公共卫生, 2026 , 42 (7) : 769 -774 . DOI: 10.11847/zgggws1148746
Yuge ZHANG, Lu WANG, Lanling WANG, Jinlang LYU, Zhanbo SUN, Yuelong JI, Shusheng LUO, Jue LIU, Guojie LIU, Haijun WANG. Associations of early-pregnancy BMI and body fat percentage with macrosomia under the updated international obesity definition: a birth cohort study[J]. Chinese Journal of Public Health, 2026 , 42 (7) : 769 -774 . DOI: 10.11847/zgggws1148746
Year 2026 volume 42 Issue 7
76
29
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Article Info
doi: 10.11847/zgggws1148746
  • Receive Date:2025-08-26
  • Online Date:2026-10-23
  • Published:2026-07-10
Article Data
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History
  • Received:2025-08-26
  • Revised:2025-12-13
  • Accepted:2026-03-07
Affiliations
    1School of Public Health, Shandong Second Medical University, Weifang 261053, China
    2Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China
    3Peking University Health Science Center-Weifang Joint Research Center for Maternal and Child Health, Beijing 100191, China
    4Weifang Maternal and Child Health Hospital, Weifang 261021, China
    5Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China

Corresponding:

LIU Guojie, E-mail:
WANG Haijun, E-mail:
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表12种不同金属材料的力学参数
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Family
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Number of
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Number of
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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