Gestational Diabetes Mellitus as an Effect Modifier of the Association of Gestational Weight Gain with Perinatal Outcomes: A Prospective Cohort Study in China

Abstract

The association of gestational weight gain (GWG) with perinatal outcomes seems to differ between women with and without gestational diabetes mellitus (GDM). Whether GDM is an effect-modifier of the association has not been verified. This study aimed to assess the modifying effect of GDM on the association of GWG with perinatal outcomes. Data on 12,128 pregnant women (3013 with GDM and 9115 without GDM) were extracted from a prospective, multicenter, cohort study in China. The associations of total and trimester-specific GWG rates (GWGR) with perinatal outcomes, including small size for gestational age, large size for gestational age (LGA), preterm birth, cesarean delivery, and gestational hypertension disorders, were assessed. The modifying effect of GDM on the association was assessed on both multiplicative and additive scales, as estimated by mixed-effects logistic regression. As a result, total GWGR was associated with all of the perinatal outcomes. GDM modified the association of total GWGR with LGA and cesarean delivery on both scales (all p < 0.05) but did not modify the association with other outcomes. The modifying effect was observed in the third trimester but not in the first or the second trimester. Therefore, maternal GWG is associated with perinatal outcomes, and GDM modifies the association with LGA and cesarean delivery in the third trimester.

Weekly Weight Gain in Women with Gestational Diabetes Mellitus and Neonatal Birth Weight — China, 2011–2021

“…Our study stratified participants into nine subgroups aligned with their BMI at GDM diagnosis, to accommodate the cumulative effects of metabolic status and GWG ( 11 ). A subsequent analysis of the correlation between weight at GDM diagnosis and fetal birth weight revealed a direct correlation.…”

“…In conclusion, clinicians should monitor weekly GWG post-GDM diagnosis closely. It's imperative to conduct interventional studies to understand factors contributing to appropriate GWG, such as diet (10), and develop comprehensive weight management guidelines for women with GDM.…”

Vitamin D Supplementation for the Outcomes of Patients with Gestational Diabetes Mellitus and Neonates: A Meta-Analysis and Systematic Review

“…For example, the incidence of postpartum type 2 diabetes in GDM women is signifcantly higher than that of normal pregnant women, and the risk of metabolic syndrome in their ofspring increases [6]. Previous studies [7,8] have pointed out that the incidence of GDM has increased signifcantly in recent years with changes in lifestyle and increasing maternal age. Some studies [9,10] have pointed out that the incidence of GDM in China is at the middle level, whereas it is at the upper level in the world, and the incidence of GDM is as high as 15.08%.…”

Optimal Gestational Weight Gain for Women with Gestational Diabetes Mellitus — China, 2011–2021

“…Excessive gestational weight gain (GWG) and hyperglycemia can have additive effects on adverse pregnancy outcomes, suggesting that optimal GWG might be lower for women with gestational diabetes mellitus (GDM) ( 1 ). However, there is a lack of guidelines for GWG among women with GDM.…”