Associations of Pre-pregnancy Body Mass Index and Gestational Weight Gain with Gestational Diabetes Mellitus: a Cohort Study in Southwest China

LIANG Yi, LI Dan-ting, CHEN Meng-xue. et al

Abstract

To determine the associations of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with gestational diabetes mellitus (GDM). Methods A prospective cohort of pregnant women were screened for GDM at 24-28 weeks of gestation between 2013 and 2015, resulting in a sample of 3 593 with GDM and 15 346 without GDM. The body mass, plasma glucose, and height data of the participants were collected by the local medical workers. Multivariate logistic regression analyses were performed to determine the associations of pre pregnancy body mass index and weight gain during pregnancy with GDM. Results The participants with pre pregnancy overweight 〔odds ratio(OR)=2.44,95% cofidence interval(CI)1.98-2.99〕 and obesity (OR=4.98,95%CI 2.52-9.91) were more likely to develop GDM. According to the Institute of Medicine (IOM) criteria, excessive GWG in the first trimester occurred in 8.46% of the women, compared with 55.07% in the second trimester. After adjustment for age at delivery and pre pregnancy BMI, high GWG in the first trimesters in advanced maternal age (age at delivery≥35 yr.) group (OR=1.42,95%CI 1.02-2.28) was a risk factor for GDM while the OR value of the non-advanced maternal age (age at delivery≤35 yr.) group was not statistically significant. In second trimesters, both advanced maternal age group (OR=1.59,95%CI 1.14-1.88) and non-advanced maternal age group (OR=1.49,95%CI 1.20-1.72) in high GWG were associated with high risk of GDM. Conclusion Pre pregnancy overweight and obesity and excessive GWG during early and second trimesters of pregnancy may increase the risk of GDM in women in Southwestern China.

 

Keywords: Gestational weight gain, Gestational diabetes, Pre-pregnancy body mass index 

 

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References


American Diabetes Association. Gestational diabetes mellitus. Diabetes Care,2000,23 Suppl 1;S77-S79.

ZHU WW. YANG HX, WEI YM, et al. Evaluation of the value of fasting plasma glucose in the first prenatal visit to diagnose gestational diabetes mellitus in China. Diabetes Care,2013,36(3):586-590.

HAPO Study Cooperative Research Group, METZGER BE, LOWE LP, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med,2008,358( 19): 1991-2002.

KIM C,NEWTON KM. KNOPP RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care,2002,25( 10); 1862-1868.

American Diabetes Association. Gestational diabetes mellitus. Diabetes Care,2004 ,27 Suppl 1:S88-S90.

SOLOMON CG, WILLETT WC, CAREY VJ, et al. Aprospective study of pregravid determinants of gestational diabetes mellitus. JAMA, 1997,278( 13): 1078-1083.

KUBOA, FERRARA A, LAURENT CA, et al. Associations between maternal pregravid obesity and gestational diabetes and the timing of pubarche in daughters. Am J Epidemiol.2016,184(1) ;7-14.

OGONOWSKI J, MIAZGOWSKI T, KUCZY jSKA M, et al. Pregravid body mass index as a predictor of gestational diabetes mellitus. Diabet Med,2009,26(4) :334-338.

CARRENOCA, CLIFTON RG, HAUTH JC, et al. Excessive early gestational weight gain and risk of gestational diabetes mellitus in nulliparous women. Obstet Gynecol, 2012-119(6): 1227-1233.

RASMUSSEN KM, YAKTINE AL. Weight gain during pregnancy: reexamining the guidelines. Washington, ГХ': National Academy Press,2009:14-73.

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care, 2012, 35 Suppl 1; S64- S71.

XI B, LIANG Y, HE T, et al. Secular trends in the prescience of general and abdominal obesity among Chinese adults, 1993-2009. Obes Rev,2012,13(3) :287-296.

PEREIRA MA, KARTASHOV Al, EBBELING CB, et al. Fast-food habits, weight gain, and insulin resistance (the CARDIA study); 15-year prospective analysis. Lancet,2015, 365(9453):36-42.

HAMMAN RF, WING RR, EDELSTEIN SL, et al. Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care,2006,29(9) ;2102-2107.

HEDDERSON MM. GUNDERSON EP, FERRARA A. Gestational weight gain and risk of gestational diabetes mellitus. Obstet Gynecol,2010,115(3);597-604.

HERRING SJ, OKEN E, RIFAS-SHIMAN SL, et al. Weight gain in pregnancy and risk of maternal hyperglycemia. Am J Obstet Gynecol,2009,201 (1):61. el-e7 [2018-01-03]. https;//doi. org/10. 1016/j. ajog. 2009. 01. 039.

TOVAR A, MUST A, BERMUDEZ OI. et al. The impact of gestational weight gain and diet on abnormal glucose tolerance during pregnancy in Hispanic women. Matern Child Health J , 2009,13(4): 520-530.

GORBERSC, TREMBLAY M, MOHER D, et al. A comparison of direct vs. self-report measures for assessing height, weight and body mass index; a systematic review. Obes Rev,2007,8(4) :307-326.


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