The effect of pre-pregnancy body mass index and excessive gestational weight gain on the risk of gestational diabetes in advanced maternal age

Abstract

Background and purposeWith the popularization of a two-child policy in China, the number of pregnant women of advanced maternal age will increase steadily. We aimed to assess the association between pre-pregnancy body mass index (BMI) and weight gain in the first and second trimester and the risk of gestational diabetes (GDM) in the advanced maternal age group and control group defined as maternal age of 20–35 years.ResultsThe risk of GDM for obesity before pregnancy was 2.707 (95% CI: 1.042–7.029) folds and 3.612 (95% CI: 1.182–11.039) folds in the control group and advanced maternal age group, respectively. Excessive weight gain in the first trimester was significant related to a higher risk of developing GDM with the odds ratio (OR) of 2.655 (95% CI: 1.265–5.571) and 4.170 (95% CI: 1.437–12.100) in the control group and advanced maternal age group, respectively.Materials and methodsThis prospective cohort study included 565 pregnant women with singleton pregnancy who were recruited in their first prenatal visit from the antenatal clinic in March and December 2016. Maternal weight was recorded before pregnancy, in the first prenatal visit and at the time of screening oral glucose tolerance test (OGTT). All women underwent 2 h 75g-OGTT at 24–28 weeks (24 weeks on average). GDM was diagnosed according to the standards issued by the Ministry of Health of China in 2011.ConclusionsElevated pre-pregnancy BMI independently increases the risk of GDM, particularly in advanced maternal age. Excessive weight gain in the first trimester is significantly associated with the incidence of GDM regardless of pre-pregnancy BMI.

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

“…We did not have any information on family history of diabetes, which is one well‐known risk factor for GDM. We were also missing data on gestational weight gain; excessive weight gain is known to associated with GDM . Data on lifestyle factors such as physical activity, diet and sleeping patterns were also missing.…”

Gestational weight management and pregnancy outcomes among women of advanced maternal age

“…Association of pre-pregnancy weight and pregnancy outcomes for women with AMA. Age is a risk factor for pre-pregnancy overweight (2), and overweight can trigger GDM, HDCP, macrosomia and other adverse pregnancy outcomes (9–11). In this study, we demonstrated that women of AMA and overweight were more likely to develop GDM than women with normal pre-pregnancy BMIs.…”

“…In this study, we demonstrated that women of AMA and overweight were more likely to develop GDM than women with normal pre-pregnancy BMIs. A previous study demonstrated that the risk of developing GDM among women who were overweight before pregnancy was greater than the risk among pregnant women with normal pre-pregnancy weights (2). The body's glucose tolerance becomes impaired with age due to gradual islet β-cell dysfunction (12), and being overweight is associated with insulin resistance, insulin secretion abnormalities, and insulin receptor abnormalities(1).…”

“…Since the implementation of the two-child policy, the proportion of pregnant women of advanced maternal age (AMA, pregnant women >35 years of age) has increased; this proportion accounts for approximately 60% of all pregnancies, and half of these women are older than 40 years (1). Women of AMA are more frequently overweight before the pregnancy (2), and are more likely to have had internal and surgical diseases, and are more likely to be multiparas; in addition, age is an independent risk factor for maternal and child adverse outcomes (3). Therefore, AMA pregnancy management aims to improve pregnancy outcomes.…”

Postpartum Comfort and Breastfeeding Behavior of Primipara Obese and Non-Obese Mothers

“…Gestational diabetes and hypertensive diseases induced by pregnancy, which are observed frequently in maternal obesity, bring up the risks such as operative birth and anesthesia complications. An increase in the preterm birth rates, macrosomia, shoulder dystocia, and intrauterine, neonatal, or infant mortality are more frequent in obese mothers compared to mothers that have a normal body mass index (BMI) (3)(4)(5)(6)(7). In the literature, it was declared that maternal obesity was associated with fetal macrosomia, preterm birth, a low birth weight, neonatal hyperinsulinemia, and an increased need for neonatal intensive care (8,9).…”