Pre-pregnancy weight change and incidence of gestational diabetes mellitus: A finding from a prospective cohort study

Abstract

Aims: In a population-based cohort study we examined the associations between early adult pre-pregnancy weight change and the risk of gestational diabetes mellitus (GDM). Methods:The study included 3,111 women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health. These women have been surveyed regularly since 1996. Women without diabetes and GDM were followed-up between 2003 and 2012.Generalized estimating equations were used to assess the effect of baseline (1996, mean age 20 years) and pre-pregnancy body mass index (BMI) and the pre-pregnancy weight changes on the incidence of GDM. The full models were adjusted for sociodemographic and lifestyle factors.Results: From 2003-2012, 229 GDM cases (4.4%) were reported in 5,242 pregnancies.Relative to normal BMI women, obese women at baseline (RR: 1.8, 95% CI: 1.1, 2.8) and prior to pregnancy (RR: 2.7, 95% CI: 2.0, 3.6) were at greater risk of GDM. Weight gains prior to each study pregnancy were strongly associated with increased GDM risk with an adjusted RR ranging from 2.0 to 2.9. Within under/normal range of BMI, women with a moderate/high (>2.5%/year) weight gain had 2.7 (95% CI: 1.3, 5.5) times the risk of GDM compared with women with stable weight. Conclusions:Early adult weight gain, even within normal BMI range, is an important risk factor for the development of GDM. Weight gain prevention from early adulthood to prior to pregnancy appears to be the main strategy to prevent the incidence of GDM.

Gestational diabetes in primiparous women–impact of age and adiposity: a register‐based cohort study

“…With respect to the prevalence of GDM, the results of this study are consistent with previous findings . However, only a few previous studies have focused on the risk of GDM in primiparous women .…”

Association of maternal folate status in the second trimester of pregnancy with the risk of gestational diabetes mellitus

“…The major strength of this study was the availability of RBC folate levels during the second trimester of pregnancy in a Chinese population. Notably, previous studies have suggested that BMI before pregnancy and excessive weight gain in pregnancy are associated with the increased risk of GDM (Adane, Tooth, & Mishra, ; MacDonald, Bodnar, Himes, & Hutcheon, ). In the current study, we did not include these factors in our adjusted models, although maternal age, parity, and BMI at enrollment were adjusted.…”

The Impact of Prepregnancy Body Mass Index and Gestational Weight Gain on Perinatal Outcomes for Women With Gestational Diabetes Mellitus

“…Cho, Hur, and Lee () found significant correlations between GWG in the early stages of pregnancy and GDM, gestational hypertension, large‐for‐gestational‐age births, macrosomia, and primary cesarean delivery. Adane, Tooth, and Mishra () found that compared with women whose GWG was steady, women with underweight or average prepregnancy BMIs had a 2.7 times higher risk of developing GDM when their GWG became moderate or high (>2.5% per year).…”