A Research Blog

Cheung Yin BinAs part of an international research collaboration, Professor Cheung Yin Bun of the Centre for Quantitative Medicine (CQM) at Duke-NUS Medical School, developed a set of gestational weight gain (GWG) charts and published them in the prestigious American Journal of Clinical Nutrition [1]. Using prospectively collected weight measurements of pregnant women from 14 to 41 weeks of gestation and statistical methodology for longitudinal data analysis, the team developed not only a conventional, cross-sectional GWG chart but also longitudinal GWG charts, which takes prior weight status into account. That is, the (longitudinal) GWG chart for a woman is calibrated according to her weight in the previous visit, as opposed to using one chart for all women or one chart for a woman at all time.

A recent systematic review of methodological quality of the development of GWG charts conducted by another international team assessed three domains of quality: study design, statistical methods and reporting methods, and summarized them as a methodological quality score (%) [2]. Among all charts eligible for review, the median methodological score was 53%. The charts developed at CQM scored 85%, the highest in this review. Furthermore, the study by CQM is one of the only two in the review that provide z-scores in addition to percentile curves.     

“This class of methods has a wide range of applications,” said Professor Cheung.  “For example, our team has also used it to develop a new set of cognitive function standards for older Singaporeans [3] and foetal growth standards in the GUSTO birth cohort [4].”



[1] Xu J, Luntamo M, Kulmala T, Ashorn P, Cheung YB. A longitudinal study of weight gain in pregnancy in Malawi: unconditional and conditional standards. American Journal of Clinical Nutrition 2014; 99:296-301.

[2] Ohadike CO, Cheikh-Ismail L, Ohuma EO, Giuliani F, Bishop D, Kac G, et al. Systematic review of the methodological quality of studies aimed at creating gestationalweight gain charts. Advances in Nutrition 2016: 7: 313-322.

[3] Cheung YB, Xu Y, Feng L, Feng L, Nyunt MSZ, Chong MS, et al. Unconditional and conditional standards using cognitive function curves for the Modified Mini-Mental State Examination. American Journal of Geriatric Psychiatry 2015; 23:915-24.

[4] Xu Y, Lek N, Cheung YB, Biswas A, Su LL, Kwek KYC, et al. Unconditional and conditional standards for fetal abdominal circumference and estimated fetal weight in an ethnic Chinese population. BMC Pregnancy and Childbirth 2015; 15:141.


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