Influence of maternal weight gain on birth weight: a gestational diabetes cohort

Abstract

Objective Our objective was to evaluate gestational weight gain (GWG) patterns and their relation to birth weight. Subjects and methods We prospectively enrolled 474 women with gestational diabetes mellitus (GDM) at a university hospital (Porto Alegre, Brazil, November 2009-May 2015). GWG was categorized according to the 2009 Institute of Medicine guidelines; birth weight was classified as large (LGA) or small (SGA) for gestational age. Adjusted relative risks (aRRs) and 95% confidence intervals (95% CIs) were determined. Results Adequate GWG occurred in 121 women [25.5%, 95% CI: 22, 30%]; excessive, in 180 [38.0%, 95% CI: 34, 43%]; and insufficient, in 173 [36.5%, 95% CI: 32, 41%]. In women with normal body mass index (BMI), the prevalence of SGA was higher in those with insufficient compared to adequate GWG (30% vs. 0%, p < 0.001). In women with BMI ≥ 25 kg/m2, excessive GWG increased the prevalence of LGA [aRR 2.58, 95% CI: 1.06, 6.29] and protected from SGA [aRR 0.25, 95% CI: 0.10, 0.64]. Insufficient vs. adequate GWG did not influence the prevalence of SGA [aRR 0.61, 95% CI: 0.31, 1.22]; insufficient vs. excessive GWG protected from LGA [aRR 0.46, 95% CI: 0.23, 0.91]. Conclusions One quarter of this cohort achieved adequate GWG, indicating that specific ranges have to be tailored for GDM. To prevent inadequate birth weight, excessive GWG in women with higher BMI and less than recommended GWG in normal BMI women should be avoided; less than recommended GWG may be suitable for overweight and obese women.

Profile of Pregnant Women with Gestational Diabetes Mellitus at Increased Risk for Large for Gestational Age Newborns

“…Additionally, Mastella et al 27 found that both AWG and IWG decreased the risk for LGA newborns in pregnant women with GDM. On the other hand, Vesco et al 28 noted that WG below recommendations decreases LGA newborns, but increases the risk of SGA newborns.…”

“…19 Miao et al 25 found a higher incidence of macrosomia among pregnant women with EWG, as did Alberico et al, 26 who observed that EWG during pregnancy was significantly associated with macrosomia, with a 2.6-fold higher risk in comparison with the recommended WG. 25,26 Mastella et al 27 found that EWG during pregnancy was an independent risk factor for LGA newborns, and that WG during the 3 rd trimester was also associated with LGA newborns. In the present study, EWG was not a risk factor for the birth of LGA newborns.…”

Ganho De Peso Gestacional E Fatores Associados Em Gestantes E Recém-Nascidos

“…Visualizando os resultados é possível observar que as prevalências do GPG se modificam de acordo com a população estudada, e, ainda assim, as prevalências apresentam--se maiores quando comparadas ao presente estudo. Conforme artigos regionais, realizados em Pelotas/ RS e Porto Alegre/RS, entretanto, observaram-se elevadas prevalências para o GPG adequado e excessivo (36% adequado, 25,5% excessivo e 33,6% adequado e 38% excessivo) (CASTILLO; SANTOS; MATIJASEVICH, 2016;MASTELLA et al, 2018). Desse modo, percebe--se que os achados se assemelham aos do presente estudo e pode-se observar uma elevada prevalência de GPG adequado entre as populações.…”

The transcriptome-wide association search for genes and genetic variants which associate with BMI and gestational weight gain in women with type 1 diabetes

“…For a long time it was believed that it stemmed from maternal hyperglycemia; however, even though their glycemic goals have been achieved (HbA1c < 6.0%), large for gestational age (LGA) or macrosomic neonates births are more frequent among these women than in the general population (Scifres et al 2014 ; Bashir et al 2019 ; Dori-Dayan et al 2020 ). Thus, there must be other potential contributors to adverse maternal and fetal outcomes (Secher et al 2014 ; Mastella et al 2018 ; Rys et al 2018 ). Among them are also those which affect the general population—maternal body lipids, pre-pregnancy BMI and GWG (McWhorter et al 2018 ).…”