Excessive gestational weight gain in the first and second trimester is a risk factor for gestational diabetes mellitus among women pregnant with singletons: A repeated measures analysis

• Published in: Journal of diabetes investigation Vol. 11; no. 6; pp. 1651 - 1660
• Main Authors: Qi, Yana, Sun, Xin, Tan, Jing, Zhang, Guiting, Chen, Meng, Xiong, Yiquan, Chen, Peng, Liu, Chunrong, Zou, Kang, Liu, Xinghui
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.11.2020; John Wiley and Sons Inc; Wiley
• Subjects: Adult; Age; Anemia; Biomarkers - analysis; Blood Glucose - analysis; Body Mass Index; Cardiovascular disease; China; China - epidemiology; Diabetes mellitus; Diabetes, Gestational - epidemiology; Diabetes, Gestational - metabolism; Female; Follow-Up Studies; Gestational diabetes; Gestational diabetes mellitus; Gestational Weight Gain; Glucose; Glucose tolerance; Hematology; Hepatitis; Hospitals; Humans; Hypothyroidism; In vitro fertilization; Medical records; Middle Aged; Obesity; Original; Overweight; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; Prenatal care; Prognosis; Respiratory diseases; Retrospective Studies; Risk Factors; Tuberculosis; Weight control; Within-subjects design; Womens health; Young Adult; China; Gestational diabetes mellitus; Gestational weight gain; China
• ISSN: 2040-1116; 2040-1124; 2040-1124
• DOI: 10.1111/jdi.13280

Aims/Introduction To evaluate gestational weight gain (GWG) in the first and second trimester as a risk factor for gestational diabetes mellitus (GDM) among women pregnant with singletons. Materials and Methods This was a cohort study of women with singleton pregnancies who delivered between 1 January 2013 and 31 October 2014 in a Chinese hospital. We collected data from medical records from the first antenatal visit to delivery. All pregnant women were subjected to an oral glucose tolerance test for diagnosis of GDM during the second trimester. GWG in the first and second trimester was calculated by subtracting the prepregnancy weight from weight within 4 weeks of the oral glucose tolerance test. We categorized GWG into insufficient, appropriate and excessive according to the Institute of Medicine guidelines and population quantiles. Univariable and multivariable analyses were used to determine the association between GWG and GDM risk. Results Of 10,422 pregnant women, we identified 8,356 eligible women with 1,622 (19.4%) diagnosed with GDM. Univariable analysis showed that GWG that exceeded the Institute of Medicine recommendation might be associated with risk of GDM (P < 0.05), but this association was not observed by multivariable analysis (adjusted odds ratio 1.07, [95% confidence interval 0.94–1.21]). Univariable and multivariable analyses both showed that GWG exceeding the 90th and 95th quantiles of included women, respectively, were at increased risk for GDM (adjusted odds ratio >P90 vs P10–P90 adjusted odds ratio 1.31, [95% confidence interval 1.12–1.52]; >P95 vs P5‐P95 adjusted odds ratio 1.45 [95% confidence interval 1.16–1.81]). Conclusions Excessive GWG in the first and second trimester might be a risk factor for GDM, which highlights the importance of appropriate weight gain during pregnancy. To determine whether excessive gestational weight gain in the first and second trimester is a risk factor for developing gestational diabetes (GDM) among women pregnant with singletons, we carried out this cohort study based on repeated measures data of 10,422 pregnant women in China. All pregnant women were diagnosed with GDM by the 75g oral glucose tolerance test, and gestational weight gain was categorized into insufficient, appropriate and excessive according to the Institute of Medicine guidelines and population quantiles, respectively. Our study found that excessive gestational weight gain in the first and second trimester might be a risk factor for developing GDM, highlighting the importance of maintaining appropriate weight gain during pregnancy to prevent GDM.