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

Lyu, Jinlang; Yin, Sun; Ji, Yuelong; Liu, Nana; Zhang, Suhan; Lin, Hui; Wang, Yaxin; Yang, Xuanjin; Ma, Shuai; Han, Na; Yang, Mei; Zheng, Deyou; Yang, Zhiwei; Zhang, Hongping; Jiang, Yan; Ma, Liangkun; Wang, Haijun

doi:10.46234/ccdcw2023.034

Cited by 3 publications

(5 citation statements)

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“…However, studies must also consider the interaction of various complex factors on weight gain, such as GDM disease, pre-pregnancy weight, diet management, physical activity, and blood glucose levels (25,38). Lyu et al attempted to explore optimal GDM-related GWG based on Chinese populations, and found that giving GWG rates lower than IOM recommendations was beneficial to newborn birth weight (34). We must emphasize how crucial weight management is to the treatment of GDM disease and the well-being of women and children.…”

Section: Discussionmentioning

confidence: 99%

“…Chakkalakal et al compared the lower weight gain after GDM diagnosis to delivery than women without GDM, indicating that GDM treatment can improve weight management of pregnant mothers (26). In addition, a cohort study from China reported an optimal GDM-related GWG rate for women with GDM and different pre-BMI with the goal of reducing adverse birth weight outcomes (34). The recommended range of optimal GWG rates provided by this study is lower than the range recommended by the IOM (Table 1).…”

Section: Management Objectives and Evaluation Methods Of Gdm-related Gwgmentioning

confidence: 99%

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Effects of women with gestational diabetes mellitus related weight gain on pregnancy outcomes and its experiences in weight management programs: a mixed-methods systematic review

He,

Hu,

Wang

et al. 2023

Front. Endocrinol.

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IntroductionProper controlling gestational diabetes mellitus (GDM)-related gestational weight gain (GWG) during pregnancy can optimize pregnancy outcomes and improve postpartum glucose homeostasis. This study aimed to explore the existing intervention programs, the effects on pregnancy outcomes, and the experiences of weight management for GDM-related GWG in women with GDM.MethodsThis mixed-methods systematic review was retrieved from nine databases. The retrieval time was from the database construction to September 20, 2023, and all studies were published in English and Chinese. The included records used quantitative, qualitative, or mixed methods and reported original studies of weight-related intervention regimens, effects on pregnancy outcomes, and women’s experiences and perceptions. This review used a convergent segregated approach to synthesize and integrate research findings from Joanna Briggs Institute (JBI) mixed-methods systematic reviews.ResultsThere were 16 articles that met the inclusion criteria, and the articles came from seven different countries and included 23,997 women with GDM. The meta-analysis pooled outcomes for the incidence of weight gain exceeding the Institute of Medicine (IOM) recommendations after GDM diagnosis to delivery was 0.31% (95% CI 0.21-0.42). The effectiveness of GDM-related weight interventions in reducing weight gain after GDM diagnosis was supported by quantitative evidence. The GDM-related GWG below the IOM recommendations is a protective factor (OR=0.68, 95%CI 0.48-0.97) for large for gestational Age (LGA), and above the IOM recommendations is a risk factor (OR=1.62, 95%CI 1.15-2.27) for LGA. In addition, no significant statistical significance was found in the pooled outcomes of small for gestational age (SGA). Avoiding excessive weight gain helps to optimize neonatal birth weight, pregnancy outcomes, and maternal blood glucose levels. According to qualitative survey results, some women with GDM experienced weight stigma, and a positive relationship between healthcare providers and GDM women helped in weight management.ConclusionFollowing a diagnosis of GDM, weight management interventions positively affected GWG and pregnancy outcomes. In order to improve compliance and safety of weight management in women with GDM, criteria and interventions for weight gain associated with GDM need to be further explored and improved.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=404492, identifier CRD42023404492.

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Section: Discussionmentioning

confidence: 99%

Section: Management Objectives and Evaluation Methods Of Gdm-related Gwgmentioning

confidence: 99%

Effects of women with gestational diabetes mellitus related weight gain on pregnancy outcomes and its experiences in weight management programs: a mixed-methods systematic review

He,

Hu,

Wang

et al. 2023

Front. Endocrinol.

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“…Gestational diabetes mellitus (GDM) is a common complication during pregnancy, posing significant health risks to both the fetus and the mother. The incidence of GDM has been rising, with reported rates ranging from 1% to 14% internationally and from 2% to 18% in China (1)(2)(3)(4). Additionally, the onset of GDM is occurring at increasingly younger ages (2).…”

Section: Introductionmentioning

confidence: 99%

Association between MTHFR gene C677T polymorphism and gestational diabetes mellitus in Chinese population: a meta-analysis

Tan,

Chen

2023

Front. Endocrinol.

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Background and purposeThe relationship of the methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism with the incidence of gestational diabetes mellitus (GDM) in the Chinese population remains controversial. This study aimed to further clarify the effect of the MTHFR gene C677T polymorphism on GDM risk among Chinese pregnant women based on current evidence.MethodsSeveral databases were searched up to July 29, 2023 for relevant case-control studies. The numbers of patients with and without the T allele of the MTHFR gene C677T polymorphism in the GDM and control groups were determined, and all statistical analyses were performed by RevMan 5.3 software and STATA 15.0 software. Trial sequential analysis (TSA) was performed by TSA version 0.9 beta software to determine the required information size.ResultsA total of 17 case-control studies involving 12345 Chinese participants were included. The pooled results demonstrated that the T allele of the MTHFR gene C677T polymorphism was significantly associated with an increased risk of GDM, which was manifested by the five gene models of the MTHFR C677T polymorphism [T vs. C: odds ratio (OR)=1.59, P=0.03; TT vs. CC: OR=2.24, P<0.001; TC vs. CC: OR=1.28, P=0.05; (TT+TC) vs. CC: OR=1.55, P=0.003; TT vs. (TC+CC): OR=1.89, P<0.001]. Subgroup analysis based on the regions indicated that the significant relationship between the T allele of the MTHFR gene C677T polymorphism and an increased risk of GDM was detected only among the southern population [T vs. C: OR=1.62, P=0.09; TT vs. CC: OR=2.22, P=0.004; TC vs. CC: OR=1.17, P=0.28; (TT+TC) vs. CC: OR=1.43, P=0.03; TT vs. (TC+CC): OR=1.97, P=0.006]. TSA plots showed that the information sizes for the association between the MTHFR gene C677T polymorphism and GDM risk were sufficient in the homozygote (TT vs. CC) and recessive (TT vs. TC+CC) models.ConclusionThe MTHFR gene C677T polymorphism is closely related to susceptibility to GDM in the southern Chinese population, and the C-T mutation serves as an important genetic risk factor for GDM. More well-designed large case-control studies are needed to further confirm the above findings.

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“…Female GDM patients’ records from 2011 to 2021 were analyzed for this project. All information was extracted from electronic medical records, details of which have been discussed in a previous study ( 6 ). Subjects’ weights, usually not assessed during the 75-g oral glucose tolerance test (OGTT), were documented a week before or after the activity to obtain more comprehensive data.…”

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confidence: 99%

“…Essential data were collected from medical records, which included maternal age, weight prior to pregnancy, week of GDM diagnosis, weight at time of GDM diagnosis, weight before delivery, weeks remaining until delivery, and neonatal birth weight. The diagnostic criteria for GDM are the same as in previous study ( 6 ).…”

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confidence: 99%

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

Liu¹,

Lyu²,

Wang³

et al. 2023

China CDC Weekly

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What is already known about this topic? Elevated gestational weight gain (GWG) during pregnancy among women diagnosed with gestational diabetes mellitus (GDM) is correlated with an increased instance of large for gestational age (LGA) and macrosomia. However, it remains uncertain whether managing weekly GWG following a GDM diagnosis positively impacts fetal birth weight. What is added by this report? Our study found that GWG following GDM diagnosis correlates positively with the risk of LGA and macrosomia among all body mass index (BMI) subgroups, especially for overweight and obese women. What are the implications for public health practice? The results of this research highlight the importance of enforcing a more stringent regulation on GWG on a weekly basis for overweight and obese women diagnosed with GDM, particularly when considering neonatal growth.

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

Cited by 3 publications

References 10 publications

Effects of women with gestational diabetes mellitus related weight gain on pregnancy outcomes and its experiences in weight management programs: a mixed-methods systematic review

Effects of women with gestational diabetes mellitus related weight gain on pregnancy outcomes and its experiences in weight management programs: a mixed-methods systematic review

Association between MTHFR gene C677T polymorphism and gestational diabetes mellitus in Chinese population: a meta-analysis

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

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