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We aimed to explore the potential relationship based on a China birth cohort while adjusting by multiple factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>China birth cohort study conducted from 2017 to 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>The study finally included 114\u2009672 singleton pregnancies in the 6\u201314 weeks of gestation, without missing data or outliers, loss to follow-up or abnormal conditions other than CHD. The proportion of CHD was 0.65% (749 cases).<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary and secondary outcome measures<\/jats:title><jats:p>Association between maternal pre-pregnancy weight gain and CHD in the offspring were analysed by multivariate logistic regression, with the unadjusted, minimally adjusted and maximally adjusted methods, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The first-trimester weight gain showed similar discrimination of fetal CHD to that period of maternal body mass index (BMI) change (DeLong tests: p=0.091). Compared with weight gain in the lowest quartile (the weight gain less than 0.0\u2009kg), the highest quartile (over 2.0\u2009kg) was associated with a higher risk of fetal CHD in unadjusted (OR 1.36, 95%\u2009CI: 1.08 to 1.72), minimally adjusted (adjusted OR (aOR) 1.29, 95%\u2009CI: 1.02 to 1.62) and maximally adjusted (aOR 1.29, 95%\u2009CI: 1.02 to 1.63) models. The association remains robust in pregnant women with morning sickness, normal pre-pregnancy BMI, moderate physical activity, college\/university level, natural conception or with folic acid (FA) and\/or multivitamin supplementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and relevance<\/jats:title><jats:p>Although the association of maternal pre-pregnancy weight gain on fetal CHD is weak, the excessive weight gain may be a potential predictor of CHD in the offspring, especially in those with morning sickness and other conditions that are routine in the cohort, such as normal pre-pregnancy BMI, moderate physical activity, college\/university level, natural conception or with FA and\/or multivitamin supplementation.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2023-079635","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T02:45:35Z","timestamp":1712717135000},"page":"e079635","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Association of maternal weight gain in early pregnancy with congenital heart disease in offspring: a China birth cohort study"],"prefix":"10.1136","volume":"14","author":[{"given":"Jingjing","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaofei","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jijing","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5387-8085","authenticated-orcid":false,"given":"Lijuan","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6836-9192","authenticated-orcid":false,"given":"Qingqing","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,4,9]]},"reference":[{"key":"2024040919451332000_14.4.e079635.1","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.pop.2021.04.005","article-title":"Congenital heart disease","volume":"48","author":"Scott","year":"2021","journal-title":"Prim Care"},{"key":"2024040919451332000_14.4.e079635.2","unstructured":"The report of Chinese Birth Defect Prevention in 2012, Available: http:\/\/www.gov.cn\/gzdt\/2012-09\/12\/content_2223371.htm"},{"key":"2024040919451332000_14.4.e079635.3","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.jped.2019.07.004","article-title":"Genetic and Genomics in congenital heart disease: a clinical review","volume":"96","author":"Saliba","year":"2020","journal-title":"Jornal de Pediatria"},{"key":"2024040919451332000_14.4.e079635.4","doi-asserted-by":"crossref","DOI":"10.3390\/genes13020354","article-title":"Consanguinity and congenital heart disease susceptibility: insights into rare genetic variations in Saudi Arabia","volume":"13","author":"Albesher","year":"2022","journal-title":"Genes (Basel)"},{"key":"2024040919451332000_14.4.e079635.5","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2021.640729","article-title":"Environmental risk factors and congenital heart disease: an umbrella review of 165 systematic reviews and meta-analyses with more than 120 million participants","volume":"8","author":"Zhang","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"2024040919451332000_14.4.e079635.6","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12567"},{"key":"2024040919451332000_14.4.e079635.7","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-14-152","article-title":"Prevalence of congenital heart defect in Guangdong province, 2008-2012","volume":"14","author":"Wu","year":"2014","journal-title":"BMC Public Health"},{"key":"2024040919451332000_14.4.e079635.8","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.34130"},{"key":"2024040919451332000_14.4.e079635.9","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23507"},{"key":"2024040919451332000_14.4.e079635.10","doi-asserted-by":"crossref","unstructured":"Hashim ST , Alamri RA , Bakraa R , et al . n.d. 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