{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T07:20:51Z","timestamp":1789802451735,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82173608"],"award-info":[{"award-number":["82173608"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82473644"],"award-info":[{"award-number":["82473644"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82404362"],"award-info":[{"award-number":["82404362"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The differential impact of pre\u2010pregnancy body mass index (BMI) on large for gestational age (LGA) risk by gestational diabetes mellitus (GDM) status remains unquantified. We aimed to assess whether GDM modifies the association between pre\u2010pregnancy BMI and LGA to inform precision prevention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective cohort study, 34\u2009031 pregnant women enrolled at Hunan Provincial Maternal and Child Health Care Hospital (2013\u20132019) were stratified by GDM status. Multivariable logistic regression and restricted cubic spline (RCS) models adjusted for sociodemographic, behavioral, and clinical covariates evaluated the association between pre\u2010pregnancy BMI and LGA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      LGA incidence was significantly higher in GDM than non\u2010GDM pregnancies (14.8% vs. 11.9%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Adjusted models demonstrated a steeper BMI\u2010LGA dose\u2013response gradient in GDM: each 1\u2010unit BMI increase conferred 20% higher odds (adjusted odds ratio [aOR]: 1.20, [95% confidence interval [CI]: 1.17, 1.23]) versus 11% in non\u2010GDM pregnancies (aOR: 1.11, [1.09, 1.12]). Obesity amplified LGA risk more substantially in GDM (aOR: 6.66, [4.27, 10.39]) than non\u2010GDM pregnancies (aOR: 2.78, [2.00, 3.87]). RCS models revealed nonlinear BMI\u2010LGA trajectories in both cohorts (reference level: 21.05 for GDM and 26.18 for non\u2010GDM). Associations remained consistent across demographic subgroups. Notably, significant interaction effects occurred exclusively in non\u2010GDM pregnancies, with multigravida (aOR: 1.13) exhibiting a stronger BMI\u2010LGA association than primigravida (aOR: 1.08).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>GDM status significantly modifies the relationship between pre\u2010pregnancy BMI and LGA risk, identifying a threshold that substantially increases risk in women with GDM and revealing subgroup\u2010specific vulnerabilities. These findings suggest that incorporating pre\u2010pregnancy BMI and estimated risk of developing GDM into early risk stratification can help identify high\u2010risk pregnancies, thereby guiding targeted antenatal monitoring and individualized interventions of varying stringency to prevent LGA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70981","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T09:56:02Z","timestamp":1774346162000},"page":"1496-1506","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gestational diabetes status modifies pre\u2010pregnancy\n                    <scp>BMI<\/scp>\n                    associations with large for gestational age: A prospective cohort study in central China"],"prefix":"10.1002","volume":"174","author":[{"given":"Yuhang","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Health Statistics, Xiangya School of Public Health Central South University  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiye","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, Xiangya School of Public Health Central South University  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Xiangtan Central Hospital  Xiangtan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizhang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, Xiangya School of Public Health Central South University  Changsha Hunan China"},{"name":"Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health Central South University  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiabi","family":"Qin","sequence":"additional","affiliation":[{"name":"School of Public Health Kunming Medical University  Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1689-7257","authenticated-orcid":false,"given":"Tingting","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, Xiangya School of Public Health Central South University  Changsha Hunan China"},{"name":"NHC Key Laboratory of Birth Defect for Research and Prevention Hunan Provincial Maternal and Child Health Care Hospital  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000425667.10377.60"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000141442.59573.cd"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61605-5"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.14787"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2012.01412.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2009.09.001"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-03071-y"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu14163347"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2024.2316732"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18856"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1478907"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2023-001931"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14599"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0104779"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(16)30217-0"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002-020311"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/biom5043142"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000471488"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13777"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu14051072"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/133.11.3449"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01185.x"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000002077"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14064"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-9-421"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70981","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.70981","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70981","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T06:34:12Z","timestamp":1789799652000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.70981"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,24]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/ijgo.70981"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.70981","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,24]]},"assertion":[{"value":"2025-12-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}