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Objective:To analyze the validity of an enhanced nutrition management model for all pregnant women in reducing the incidence of macrosomia.Methods:This retrospective cohort study utilized data from the Beijing Birth Cohort database established by Beijing Obstetrics and Gynecology Hospital, Capital Medical University. A total of 73 193 pregnant women who underwent regular prenatal examinations and delivered at the hospital between January 2018 and December 2023 were consecutively included. From 2018 to 2020, all participants received nutrition education, and high-risk pregnancies predisposed to macrosomia were referred to nutrition clinics for further follow-up. From 2021 to 2023, obstetricians participated in nutritional assessments and gestational weight gain guidance, with repeated nutrition evaluations and education provided during early, mid, and late pregnancy. A multidisciplinary team (obstetrics and nutrition departments) collaborated to implement an enhanced nutrition management model for all pregnant women. General data, parity, gestational age at delivery, neonatal birth weight, and clinical information were collected. Annual incidences of macrosomia and low birth weight were calculated. Chi-square tests and variance analysis were used to analyzed yearly changes in macrosomia rates and evaluate the impact of the two-phase management strategies on macrosomia incidence, thereby to explore the validity of an enhanced nutrition management model for all pregnant women in reducing the incidence of macrosomia.Results:The number of deliveries included annually from 2018 to 2023 was 14 578, 15 413, 11 496, 11 146, 10 396, and 10 164, respectively. Maternal pre-pregnancy body mass indices in 2022 to 2023 were higher than those in 2018 to 2021 [(22.26±3.50) and (22.23±3.65) vs (21.87±3.27), (21.82±3.31), (21.86±3.34) and (21.94±3.39) kg/m2, respectively (all P<0.05)]. Neonatal birth weights in 2021 to 2022 were lower than those in 2018 to 2020 [(3 271±514) and (3 270±513) vs (3 323±504), (3 314±500), and (3 315±510) g], and the birth weight in 2023 was further reduced compared to that in 2018 to 2022 [(3 236±506) vs (3 323±504), (3 314±500), (3 315±510), (3 271±514) and (3 270±513) g] (all P<0.05). The incidence of macrosomia in 2021 to 2022 was lower than those in 2018 to 2020 (5.55%, 5.75% vs 6.97%, 6.68%, 6.67%), and the incidence in 2023 further decreased compared to those in 2018 to 2022 (4.16% vs 6.97%, 6.68%, 6.67%, 5.55%, 5.75%) (all P<0.05). Conclusion:The enhanced nutrition management model for all pregnant women effectively reduces the incidence of macrosomia, demonstrating significant clinical value for widespread implementation.

Objective:To observe and analyze the intraocular stability of intraocular lens (IOL) with different haptic designs after cataract surgery by swept-source optical coherence tomography (SS-OCT) and analyze its influencing factors.Methods:A cohort study was conducted.Medical records of 130 consecutive patients (130 eyes) diagnosed with age-related cataract, who underwent phacoemulsification and IOL implantation at The First Affiliated Hospital of Zhengzhou University from August 2021 to August 2022 were collected.According to the type of IOL implanted, the patients were divided into four groups, L-haptic group with 34 cases (34 eyes), modified C-haptic group with 30 cases (30 eyes), plate-haptic group with 36 cases (36 eyes), four-haptic group with 30 cases (30 eyes).Before surgery, the patient's axial length and IOL diopter were measured with an optical biometer, and the angle kappa and angle alpha were measured with corneal topography.At 3 months after surgery, the anterior chamber depth, decentration and tilt of IOL, the space area between IOL and posterior capsule (AREAP) of the four groups were measured using SS-OCT.And anterior chamber depth changes and diopter changes were calculated.This study complied with the Declaration of Helsinki.The study protocol was reviewed and approved by the Medical Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2022-KY-1222-002).All subjects were aware of the purpose and significance of this study and voluntarily signed the informed consent form.Results:The average decentration and tilt of the modified C-haptic, L-haptic, plate-haptic, and four-haptic IOL decreased successively at 3 months after surgery, with no statistically significant differences ( H=7.055, F=5.162; all P>0.05).The postoperative anterior chamber depth, the anterior chamber depth change, the diopter change and the AREAP of the modified C-haptic, L-haptic, plate-haptic, and four-haptic IOL decreased successively at 3 months after surgery, and the differences were statistically significant (all P<0.05).Preoperative angle kappa was positively correlated with postoperative 3-month IOL tilt ( r=0.554, P<0.001).Preoperative angle alpha was positively correlated with postoperative 3-month IOL tilt ( r=0.469, P<0.001).The multiple linear regression model constructed with preoperative angle kappa and preoperative angle alpha as independent variables and IOL tilt as dependent variable was statistically significant ( F=39.526, P<0.001, R2=0.384).For every 1 mm increase in preoperative angle kappa, postoperative tilt will increase by 0.438°; for every 1 mm increase in preoperative angle alpha, postoperative tilt will increase by 0.300°. Conclusions:All four IOLs with different haptic designs have good horizontal centering stability.The plate-haptic and the four-haptic IOLs have superior vertical stability compared to L-haptic and modified C-haptic designs.Preoperative angles kappa and alpha can be used as indicators to predict postoperative IOL tilt.

Objective:To observe and analyze the intraocular stability of intraocular lens (IOL) with different haptic designs after cataract surgery by swept-source optical coherence tomography (SS-OCT) and analyze its influencing factors.Methods:A cohort study was conducted.Medical records of 130 consecutive patients (130 eyes) diagnosed with age-related cataract, who underwent phacoemulsification and IOL implantation at The First Affiliated Hospital of Zhengzhou University from August 2021 to August 2022 were collected.According to the type of IOL implanted, the patients were divided into four groups, L-haptic group with 34 cases (34 eyes), modified C-haptic group with 30 cases (30 eyes), plate-haptic group with 36 cases (36 eyes), four-haptic group with 30 cases (30 eyes).Before surgery, the patient's axial length and IOL diopter were measured with an optical biometer, and the angle kappa and angle alpha were measured with corneal topography.At 3 months after surgery, the anterior chamber depth, decentration and tilt of IOL, the space area between IOL and posterior capsule (AREAP) of the four groups were measured using SS-OCT.And anterior chamber depth changes and diopter changes were calculated.This study complied with the Declaration of Helsinki.The study protocol was reviewed and approved by the Medical Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2022-KY-1222-002).All subjects were aware of the purpose and significance of this study and voluntarily signed the informed consent form.Results:The average decentration and tilt of the modified C-haptic, L-haptic, plate-haptic, and four-haptic IOL decreased successively at 3 months after surgery, with no statistically significant differences ( H=7.055, F=5.162; all P>0.05).The postoperative anterior chamber depth, the anterior chamber depth change, the diopter change and the AREAP of the modified C-haptic, L-haptic, plate-haptic, and four-haptic IOL decreased successively at 3 months after surgery, and the differences were statistically significant (all P<0.05).Preoperative angle kappa was positively correlated with postoperative 3-month IOL tilt ( r=0.554, P<0.001).Preoperative angle alpha was positively correlated with postoperative 3-month IOL tilt ( r=0.469, P<0.001).The multiple linear regression model constructed with preoperative angle kappa and preoperative angle alpha as independent variables and IOL tilt as dependent variable was statistically significant ( F=39.526, P<0.001, R2=0.384).For every 1 mm increase in preoperative angle kappa, postoperative tilt will increase by 0.438°; for every 1 mm increase in preoperative angle alpha, postoperative tilt will increase by 0.300°. Conclusions:All four IOLs with different haptic designs have good horizontal centering stability.The plate-haptic and the four-haptic IOLs have superior vertical stability compared to L-haptic and modified C-haptic designs.Preoperative angles kappa and alpha can be used as indicators to predict postoperative IOL tilt.

Objective:To analyze the validity of an enhanced nutrition management model for all pregnant women in reducing the incidence of macrosomia.Methods:This retrospective cohort study utilized data from the Beijing Birth Cohort database established by Beijing Obstetrics and Gynecology Hospital, Capital Medical University. A total of 73 193 pregnant women who underwent regular prenatal examinations and delivered at the hospital between January 2018 and December 2023 were consecutively included. From 2018 to 2020, all participants received nutrition education, and high-risk pregnancies predisposed to macrosomia were referred to nutrition clinics for further follow-up. From 2021 to 2023, obstetricians participated in nutritional assessments and gestational weight gain guidance, with repeated nutrition evaluations and education provided during early, mid, and late pregnancy. A multidisciplinary team (obstetrics and nutrition departments) collaborated to implement an enhanced nutrition management model for all pregnant women. General data, parity, gestational age at delivery, neonatal birth weight, and clinical information were collected. Annual incidences of macrosomia and low birth weight were calculated. Chi-square tests and variance analysis were used to analyzed yearly changes in macrosomia rates and evaluate the impact of the two-phase management strategies on macrosomia incidence, thereby to explore the validity of an enhanced nutrition management model for all pregnant women in reducing the incidence of macrosomia.Results:The number of deliveries included annually from 2018 to 2023 was 14 578, 15 413, 11 496, 11 146, 10 396, and 10 164, respectively. Maternal pre-pregnancy body mass indices in 2022 to 2023 were higher than those in 2018 to 2021 [(22.26±3.50) and (22.23±3.65) vs (21.87±3.27), (21.82±3.31), (21.86±3.34) and (21.94±3.39) kg/m2, respectively (all P<0.05)]. Neonatal birth weights in 2021 to 2022 were lower than those in 2018 to 2020 [(3 271±514) and (3 270±513) vs (3 323±504), (3 314±500), and (3 315±510) g], and the birth weight in 2023 was further reduced compared to that in 2018 to 2022 [(3 236±506) vs (3 323±504), (3 314±500), (3 315±510), (3 271±514) and (3 270±513) g] (all P<0.05). The incidence of macrosomia in 2021 to 2022 was lower than those in 2018 to 2020 (5.55%, 5.75% vs 6.97%, 6.68%, 6.67%), and the incidence in 2023 further decreased compared to those in 2018 to 2022 (4.16% vs 6.97%, 6.68%, 6.67%, 5.55%, 5.75%) (all P<0.05). Conclusion:The enhanced nutrition management model for all pregnant women effectively reduces the incidence of macrosomia, demonstrating significant clinical value for widespread implementation.

BACKGROUND:Endothelial injury is one of the causes of cardiovascular diseases.Human induced pluripotent stem cells are easy to obtain,have strong differentiation ability,and have less exclusiveness,and their endothelial differentiated cells can be used as ideal cells for cardiovascular disease research. OBJECTIVE:To investigate the effect and mechanism of calycosin on endothelial differentiation of human induced pluripotent stem cells and to provide technical support for microvascular regeneration. METHODS:Human induced pluripotent stem cells were divided into control group and calycosin group(1.25,2.5 μg/mL),and growth factors were added to induce single-layer endothelial differentiation.After the induction of differentiation for 8 days,the positive rate of endothelial cell marker CD144 was detected by flow cytometry.Fluorescent expressions of CD144 and CD31 were detected by the immunofluorescence method.Lentivirus RNAi GFP puromycin was used to silence human-induced pluripotent stem cell Piezo1 mRNA followed by endothelial directed differentiation.After 8 days of differentiation,the positive rate of CD144 in differentiated cells was detected by flow cytometry.The mRNA expression levels of CD144,Piezo1 and MEK were detected by qPCR. RESULTS AND CONCLUSION:(1)Compared with the control group,the positive rate of CD144 was significantly increased in the 1.25 and 2.5 μg/mL calycosin groups(P<0.05).The expressions of CD144,Piezo1,and MEK mRNA were increased in the 2.5 μg/mL calycosin group(P<0.05).The fluorescence expressions of CD144(P<0.01)and CD31(P<0.001)were significantly increased in the 2.5 μg/mL calycosin group.(2)Compared with the shNT group,CD144 positive rate and CD144,Piezo1,MEK mRNA expressions were significantly increased in the shNT + calycosin 1.25,2.5 μg/mL groups(P<0.05).Compared with the shPiezo1 group,the positive rate of CD144 and mRNA expressions of CD144,Piezo1 and MEK had no significant changes in the shPiezo1+calycosin 1.25,2.5 μg/mL groups(P>0.05).(3)It is concluded that 2.5 μg/mL calycosin promotes the differentiation of human-induced pluripotent stem cells into endothelial lineages.Calycosin promotes the downstream MEK expression,thereby promoting the endothelial differentiation of human induced pluripotent stem cells by targeting the expression level of Piezo1.

Objective To compare the effects of SARIMA,LSTM and EDM in predicting the incidence of HFRS in Weifang under different circumstances,and explore the best prediction model.Methods The monthly incidence of HFRS in Weifang from January 2011 to December 2017 was selected to construct the SARIMA model,univariate LSTM model,univariate EDM model,and SARIMAX model,multivariate LSTM model,and multivariate EDM model including meteorological factors.The monthly incidence from January 2018 to December 2018 was predicted,and the prediction effects of each model were compared.Results The MAPE of SARIMA model,univariate LSTM model,multivariate LSTM model,univariate EDM model,multivariate EDM model were 42.17%,48.40%,16.19%,55.00%,51.79%,respectively.Conclusion The multivariate LSTM model including meteorological factors had a good prediction effect on the incidence of HFRS in Weifang,and the prediction results could provide reference for the prevention and control of HFRS.

Objective To construct a predictive model for septic shock based on the propensity score matching (PSM) method and validate its effectiveness. Methods A total of 114 patients with sepsis were enrolled as study objects, and were divided into septic shock group (40 patients) and sepsis group (74 patients) according to whether they developed septic shock. PSM was performed with a ratio of septic shock to sepsis of 1∶2, resulting in the inclusion of 30 patients in the septic shock group and 60 patients in the sepsis group after matching. The levels of C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), serum amyloid A (SAA), soluble endothelial protein C receptor (sEPCR), endothelial cell-specific molecule 1 (ESM-1), clusterin (CLU), and the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score and Sequential Organ Failure Assessment (SOFA) score at admission were compared between the two groups. Cox proportional hazards regression analysis was used to identify the factors influencing septic shock, and a predictive model for septic shock was constructed and internally validated using the receiver operating characteristic (ROC) curve. Kaplan-Meier survival curves were plotted to analyze the differences in survival prognosis among patients with different expression levels of the indicators. Results After matching, there were no statistically significant differences in general information between the two groups (P>0.05). At admission, the septic shock group had higher levels of serum PCT, CRP, SAA, IL-6, sEPCR, ESM-1, and higher APACHE Ⅱ and SOFA scores, as well as a lower level of serum CLU compared with the sepsis group (P < 0.05). Cox regression analysis showed that PCT, CRP, SAA, IL-6, sEPCR, ESM-1, APACHE Ⅱ score, and SOFA score were independent risk factors for septic shock (P < 0.05), while CLU was an independent protective factor (P < 0.05). The predictive model for septic shock, constructed based on these factors, showed an internal validation accuracy of 94.44%, an area under the curve of 0.950, a sensitivity of 93.33%, and a specificity of 96.67%. Dead patients had higher levels of PCT, CRP, SAA, IL-6, sEPCR, ESM-1, and higher APACHE Ⅱ and SOFA scores, as well as a lower level of CLU at admission compared with survivors (P < 0.05). Compared with patients with low expression levels or low scores, patients with high expression levels of PCT, CRP, SAA, IL-6, sEPCR, ESM-1, and high APACHE Ⅱ and SOFA scores had higher fatality rates, while patients with high CLU expression levels had a lower fatality rate (P < 0.05). Conclusion The serum biomarkers including PCT, CRP, SAA, IL-6, sEPCR, ESM-1, CLU, and the APACHE Ⅱ and SOFA scores in sepsis patients are closely related to the occurrence of septic shock and survival prognosis. The predictive model constructed by combining these indicators can accurately predict the occurrence of septic shock.

Objective:To investigate the pharmacokinetics of cerebrospinal fluid pemetrexed following intrathecal injection chemotherapy in patients with leptomeningeal metastasis (LM) from lung adenocarcinoma and provide a basis for clinical intrathecal injection chemotherapy.Methods:A total of 21 patients with lung adenocarcinoma LM who underwent pemetrexed intrathecal injection chemotherapy via Ommaya capsule at Nanjing Drum Tower Hospital, Aiffilitated Hospital of Nanjing University Medical School from November 2019 to November 2022 were collected, and divided into 30, 40 and 50 mg groups ( n=10, n=4, n=7) according to pemetrexed dose. Cerebrospinal fluid was collected at 0, 0.5, 1, 2, 4, 6, 12, 24 and 48 h after the first intrathecal injection chemotherapy, and day 8 of each cycle for three groups. Reversed phase high performance liquid chromatography was used to determine the drug concentration in cerebrospinal fluid, to clarify the drug-related pharmacokinetic parameters, and to compare the differences in pemetrexed concentration among groups. Finally, cerebrospinal fluid pemetrexed concentration changes were observed and compared after different intrathecal injection chemotherapy cycles. Results:There were statistically significant differences in cerebrospinal fluid drug concentrations of patients in three groups at 0, 0.5, 1, 2, 4, 6, 12, 24 and 48 h after the first intrathecal injection chemotherapy (30 mg group: F=20.56, P<0.001; 40 mg group: F=27.06, P<0.001; 50 mg group: F=28.63, P<0.001), and there were statistically significant differences in the concentration of cerebrospinal fluid drugs in each dose group at 0.5, 1, 2, 4, 6 and 12 h compared to 0 h after intrathecal injection chemotherapy (all P<0.05). Compared to the 30 mg group, cerebrospinal fluid drug concentrations in the 50 mg group increased at 1, 2, 4, 6, 12 and 24 h after intrathecal injection chemotherapy, with statistically significant differences (all P<0.05). Pharmacokinetic analysis of cerebrospinal fluid pemetrexed showed that area under the concentration-time curve (AUC) 0-∞ of the 30, 40 and 50 mg groups were (5 696.12±283.32), (7 886.29±396.57), and (14 202.70±440.19) h·mg/L, respectively, with a statistically significant difference ( F=1 159.00, P<0.001) ; AUC 0-∞ increased in the 50 mg group compared to the 30 and 40 mg groups (both P<0.05) ; AUC 0-∞ increased in the 40 mg group compared to the 30 mg group ( P<0.05). The half-lives of three groups were (8.75±0.23), (11.29±0.59) and (16.42±1.23) h, respectively, with a statistically significant difference ( F=206.80, P<0.001) ; half-life was longer in the 50 mg group compared to the 30 and 40 mg groups (both P<0.05) ; half-life was longer in the 40 mg group compared to the 30 mg group ( P<0.05). The peak time of three groups were (1.55±0.10), (1.00±0.01), (1.43±0.11) h, respectively, with a statistically significant difference ( F=48.11, P<0.001) ; the peak time was shorter in the 40 and 50 mg groups compared to the 30 mg group (both P<0.05). Clearance of three groups were (7.02±2.46), (5.80±1.25) and (3.66±1.32) L/h, respectively, with a statistically significant difference ( F=6.02, P=0.009) ; clearance was decreased in the 50 mg group compared to the 30 mg group ( P<0.05). The peak concentration of three groups were (540.45±32.25), (820.75±46.47) and (1 014.78±64.96) mg/L, respectively, with a statistically significant difference ( F=207.70, P<0.001) ; peak concentration increased in the 50 mg group compared to the 30 and 40 mg groups (both P<0.05) ; peak concentration increased in the 40 mg group compared to the 30 mg group ( P<0.05). Cerebrospinal fluid drug concentrations were dynamically monitored after 4 cycles of intrathecal injection chemotherapy, in which cerebrospinal fluid pemetrexed concentrations in 30 mg group were (13.76±4.79), (11.41±7.08), (9.41±2.59) and (7.86±4.02) mg/L, respectively; 40 mg group were (14.45±6.59), (12.87±15.73), (11.24±2.48) and (9.09±3.38) mg/L, respectively; 50 mg group were (12.94±10.34), (9.72±7.62), (8.15±8.17) and (4.34±4.21) mg/L, respectively. There was a statistically significant difference in cerebrospinal fluid drug concentrations among different intrathecal injection chemotherapy cycles in 30 mg group ( F=4.04, P=0.016), and the cerebrospinal fluid drug concentration decreased in cycles 3 and 4 compared to cycle 1 (both P<0.05). There were no statistically significant differences in cerebrospinal fluid drug concentrations among different treatment cycles in 40 and 50 mg groups ( F=0.28, P=0.837; F=3.57, P=0.066) . Conclusion:Reversed phase high performance liquid chromatography method can effectively detect the pemetrexed concentration in cerebrospinal fluid; dynamic monitoring of cerebrospinal fluid pemetrexed concentration can provide a basis for the dosage and the treatment cycle of intrathecal injection chemotherapy in LM patients with lung adenocarcinoma.

Objective:To explore the characteristics of weekly gestational weight gain (GWG) in women with obesity and its correlation with the risk of macrosomia.Methods:Clinical data of women with singleton pregnancy and pre-pregnancy body mass index (PPBMI) ≥28 kg/m 2 were retrospectively analyzed, from January 2014 to December 2019, in Beijing Obstetrics and Gynecology Hospital, Capital Medical University (Beijing Maternal and Child Health Care Hospital). The participants were divided into three groups based on their PPBMI: group A (28-<30 kg/m 2), group B (30-<32 kg/m 2), and group C (≥32 kg/m 2). The study compared the characteristics of GWG among the three groups, explored the correlation between the weekly weight gain during each gestational stage and the risk of macrosomia, and discussed the impacts of the GWG pattern in women with different PPBMI on the risk of macrosomia. Chi-square (or Fisher's exact), Kruskal-Wallis, and Mann-Whitney U tests were performed for statistical analysis. Multivariate logistic regression was used to analyze the impact of weekly weight gain in specific gestational stages on macrosomia. Results:(1) A total of 2 046 participants were included in the study, with 982 in group A, 588 in group B, and 476 in group C. For all of the 2 046 cases, the median PPBMI was 30.1 kg/m 2 (29.0-31.9 kg/m 2), GWG was 10.5 kg (7.3-14.0 kg), and neonatal birth weight was 3 520 g (3 215-3 816 g) with 60 (2.9%) ≥4 500 g, and the biggest baby weighed 5 580 g. Out of the births analyzed, macrosomia occurred in 318 cases (15.5%). (2) Among the three groups (A, B and C), the differences in maternal age [32.0 years (29.0-35.0 years), 32.0 years (29.0-35.0 years) and 32.0 years (29.0-34.0 years), H=6.58] and women with a history of type 2 diabetes mellitus [0.9% (9/982), 0.3% (2/588) and 1.9% (9/476), χ2=6.61] were statistically significant (all P<0.05). (3) The weekly weight gain in each group exhibited a gradual upward trend before 20-24 weeks, reached a plateau at 24-32 weeks, peaked at 32-36 weeks, and subsequently declined. The weekly weight gain of group A in the pre-pregnancy to 14 weeks [0.14 kg/week (0.00-0.25 kg/week)], 14 to 20 weeks [0.25 kg/week (0.17-0.42 kg/week)], and 20 to 24 weeks [0.38 kg/week (0.25-0.63 kg/week)] were higher than those of group B [0.07 kg/week (－0.03-0.21 kg/week), 0.25 kg/week (0.10-0.42 kg/week), and 0.38 kg/week (0.22-0.60 kg/week)], respectively ( Z value was－3.73,－2.16, and－2.01, all P<0.05). Likewise, the weekly weight gain of group B in the above three stages were all higher than those of group C [0.07 kg/week (－0.10-0.21 kg/week), 0.17 kg/week (0.05-0.33 kg/week), and 0.25 kg/week (0.08-0.50 kg/week)], respectively ( Z value was－2.55,－3.28, and－3.25, all P<0.05). (4) The risk of macrosomia increased with the weekly weight gain in specific gestational stages in different PPBMI groups. In group A, the stages correlated with increased risk were 14-20 weeks [adjusted odd ratio ( aOR)=2.669, 95% CI: 1.378-5.169] and 20-24 weeks ( aOR=1.764, 95% CI: 1.143-2.723), while the stages were 20-24 weeks ( aOR=2.149, 95% CI: 1.156-3.996) and 36 weeks until delivery ( aOR=1.888, 95% CI: 1.268-2.810) in group B, and pre-pregnancy to 14 weeks ( aOR=3.515, 95% CI: 1.158-10.665) and 14-20 weeks ( aOR=3.021, 95% CI: 1.058-8.628) in group C (all P<0.05). The risk of macrosomia increased when the weekly weight gain of both risk-related stages in group A ( aOR=2.255, 95% CI: 1.029-4.940) ≥50th percentile, and group B ( aOR=4.399, 95% CI: 1.017-19.023) ≥75th percentile, and for group C ( aOR=3.404, 95% CI: 1.004-11.543) when the weekly weight gain above 25th percentile (all P<0.05). Conclusions:Weekly GWG demonstrates an observable gradual acceleration pattern in women with obesity. Therefore, clinical attention should be directed towards monitoring fluctuations in the weekly weight gain in this population, as excessive weekly weight gain before 24 gestational weeks is associated with an elevated risk of macrosomia.