Gestational weight gain and pregnancy outcomes in women with type 1 and type 2 diabetes mellitus

Xie, Xinglei; Liu, Jiaming; García‐Patterson, Apolonia; Chico, Ana; Mateu-Salat, Manel; Amigó, Judit; Adelantado, Juan M.; Corcoy, Rosa

doi:10.1007/s00592-023-02031-0

Cited by 7 publications

(5 citation statements)

References 43 publications

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“…In the general population, GWG above IOM recommendations decreased the risk of small for gestational age (12). Nevertheless, in our study, excessive GWG in women with type 2 diabetes was not a protective factor for small for gestational age, which was consistent with previous studies (19,24,27).…”

Section: Discussionsupporting

confidence: 93%

“…In our study, more than half of the women with type 2 diabetes experienced inappropriate GWG compared to the 2009 IOM recommendations, which was consistent with previous research ( 23 ). We found that GWG below the IOM recommendations in women with type 2 diabetes was associated with lower risks of large for gestational age, macrosomia, and preeclampsia, which was consistent with prior studies ( 24 , 25 ). Previous studies found that GWG above IOM recommendations increased the risk of neonatal hypoglycemia ( 26 ).…”

Section: Discussionsupporting

confidence: 91%

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Gestational weight gain and pregnancy outcomes in Chinese women with type 2 diabetes mellitus: evidence from a tertiary hospital in Beijing

Yan,

Jia,

Zheng

et al. 2024

Front. Endocrinol.

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ObjectiveTo examine the effects of gestational weight gain on pregnancy outcomes and determine the optimal range of weight gain during pregnancy for Chinese women with type 2 diabetes mellitus.MethodsThis retrospective cohort study included 691 Chinese women with type 2 diabetes mellitus from 2012 to 2020. The study utilized a statistical-based approach to determine the optimal range of gestational weight gain. Additionally, multivariate logistic regression analysis was conducted to assess the impact of gestational weight gain on pregnancy outcomes.Results(1) In the obese subgroup, gestational weight gain below the recommendations was associated with decreased risks of large for gestational age (adjusted odds ratio [aOR] 0.19; 95% confidence interval [CI] 0.06-0.60) and macrosomia (aOR 0.18; 95% CI 0.05-0.69). In the normal weight subgroup, gestational weight gain below the recommendations of the Institute of Medicine was associated with decreased risks of preeclampsia (aOR 0.18; 95% CI 0.04-0.82) and neonatal hypoglycemia (aOR 0.38; 95% CI 0.15-0.97). (2) In the normal weight subgroup, gestational weight gain above the recommendations of the Institute of Medicine was associated with an increased risk of large for gestational age (aOR 4.56; 95% CI 1.54-13.46). In the obese subgroup, gestational weight gain above the recommendations was associated with an increased risk of preeclampsia (aOR 2.74; 95% CI 1.02, 7.38). (3) The optimal ranges of gestational weight gain, based on our study, were 9-16 kg for underweight women, 9.5-14 kg for normal weight women, 6.5-12 kg for overweight women, and 3-10 kg for obese women. (4) Using the optimal range of gestational weight gain identified in our study seemed to provide better prediction of adverse pregnancy outcomes.ConclusionFor Chinese women with type 2 diabetes, inappropriate gestational weight gain is associated with adverse pregnancy outcomes, and the optimal range of gestational weight gain may differ from the Institute of Medicine recommendations.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 91%

Gestational weight gain and pregnancy outcomes in Chinese women with type 2 diabetes mellitus: evidence from a tertiary hospital in Beijing

Yan,

Jia,

Zheng

et al. 2024

Front. Endocrinol.

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“…It is crucial to develop effective screening techniques for early detection and treatment. GDM increases the risk of complications for maternal health, including pre-eclampsia and cesarean sections, emphasizing the need for close observation during pregnancy ( 146 , 147 ). Furthermore, the long-term consequences for mothers, such as an elevated risk of type 2 diabetes, underscore the importance of postpartum care.…”

Section: Clinical Implications and Applications Of Gdmmentioning

confidence: 99%

Genetic and inflammatory factors underlying gestational diabetes mellitus: a review

Ray,

Zeng,

Kusi

et al. 2024

Front. Endocrinol.

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Gestational diabetes mellitus (GDM) poses a significant global health concern, impacting both maternal and fetal well-being. Early detection and treatment are imperative to mitigate adverse outcomes during pregnancy. This review delves into the pivotal role of insulin function and the influence of genetic variants, including SLC30A8, CDKAL1, TCF7L2, IRS1, and GCK, in GDM development. These genetic variations affect beta-cell function and insulin activity in crucial tissues, such as muscle, disrupting glucose regulation during pregnancy. We propose a hypothesis that this variation may disrupt zinc transport, consequently impairing insulin production and secretion, thereby contributing to GDM onset. Furthermore, we discussed the involvement of inflammatory pathways, such as TNF-alpha and IL-6, in predisposing individuals to GDM. Genetic modulation of these pathways may exacerbate glucose metabolism dysregulation observed in GDM patients. We also discussed how GDM affects cardiovascular disease (CVD) through a direct correlation between pregnancy and cardiometabolic function, increasing atherosclerosis, decreased vascular function, dyslipidemia, and hypertension in women with GDM history. However, further research is imperative to unravel the intricate interplay between inflammatory pathways, genetics, and GDM. This understanding is pivotal for devising targeted gene therapies and pharmacological interventions to rectify genetic variations in SLC30A8, CDKAL1, TCF7L2, IRS1, GCK, and other pertinent genes. Ultimately, this review offers insights into the pathophysiological mechanisms of GDM, providing a foundation for developing strategies to mitigate its impact.

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“…Similarly to the risks described in the general obstetric population [3][4][5], and in women with gestational diabetes (GDM) [5,6], inadequate GWG is also associated with unfavorable pregnancy outcomes in women with pregestational diabetes. Thus, excessive GWG (eGWG) has been associated with both maternal (pregnancy-induced hypertension [7], cesarean section [7][8][9] and fetal outcomes (excessive birthweight [7][8][9][10][11], hyperbilirubinemia [11], preterm delivery, neonatal hypoglycemia and a composite of perinatal morbidity [8]). In turn, insu cient GWG (iGWG) has also been associated with birthweight-related outcomes and respiratory distress [7].…”

Section: Introductionmentioning

confidence: 99%

“…Thus, excessive GWG (eGWG) has been associated with both maternal (pregnancy-induced hypertension [7], cesarean section [7][8][9] and fetal outcomes (excessive birthweight [7][8][9][10][11], hyperbilirubinemia [11], preterm delivery, neonatal hypoglycemia and a composite of perinatal morbidity [8]). In turn, insu cient GWG (iGWG) has also been associated with birthweight-related outcomes and respiratory distress [7].…”

Section: Introductionmentioning

confidence: 99%

Gestational weight gain in women with type 1 and type 2 diabetes mellitus is related to both general and diabetes-related clinical characteristics

Xie,

Liu,

García-Patterson

et al. 2023

Hormones

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To assess gestational weight gain (GWG) according to Institute of Medicine (IOM) and its clinical predictors in women with type 1 and type 2 diabetes. MethodsRetrospective cohort study at a tertiary medical center. GWG after IOM, was assessed both uncorrected and corrected for gestational age. General and diabetes-related characteristics were analyzed as GWG predictors. ResultsWe evaluated 633 pregnant women with type 1 and type 2 diabetes. GWG uncorrected for gestational age was insu cient (iGWG) in 20.4%, adequate in 37.1% and excessive (eGWG) in 42.5%. GWG predictors included general (height, prepregnancy body mass index category, multiple pregnancy) and diabetesrelated characteristics. Neuropathy and follow-up length were associated with iGWG (OR 3.00, 95% CI 1.22-7.37; OR 0.92, 95% CI 0.86-0.97 respectively) while pump use and third trimester insulin dose were associated with eGWG (OR 1.68, 95% CI 1.07-2.66; OR 3.64, 95% CI 1.88-7.06 respectively). Independent predictors for corrected GWG also included general and diabetes-related characteristics. ConclusionIn this cohort of women with type 1 and type 2 diabetes, inadequate GWG was common at the expense of eGWG and associated clinical characteristics were both general and diabetes-related. Clinical care during pregnancy for these women may favor weight gain.

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Gestational weight gain and pregnancy outcomes in women with type 1 and type 2 diabetes mellitus

Cited by 7 publications

References 43 publications

Gestational weight gain and pregnancy outcomes in Chinese women with type 2 diabetes mellitus: evidence from a tertiary hospital in Beijing

Gestational weight gain and pregnancy outcomes in Chinese women with type 2 diabetes mellitus: evidence from a tertiary hospital in Beijing

Genetic and inflammatory factors underlying gestational diabetes mellitus: a review

Gestational weight gain in women with type 1 and type 2 diabetes mellitus is related to both general and diabetes-related clinical characteristics

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