The Impact of Gestational Weight Gain and Diet on Abnormal Glucose Tolerance During Pregnancy in Hispanic Women

Tovar, Alison; Must, Aviva; Bermúdez, Odilia I.; Hyatt, Raymond R.; Chasan‐Taber, Lisa

doi:10.1007/s10995-008-0381-x

Cited by 62 publications

(43 citation statements)

References 61 publications

(61 reference statements)

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“…However, we found a clear association between excessive GWG and the risk of GDM. Our analysis does not provide evidence of effect modification by maternal BMI category, which has been suggested previously [15,37]. However, stratified data to assess this were only reported in four studies [17,22,33,34].…”

Section: Discussioncontrasting

confidence: 51%

Excessive gestational weight gain prior to glucose screening and the risk of gestational diabetes: a meta-analysis

et al. 2015

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Aims/hypothesis Excessive gestational weight gain (GWG) may be a risk factor for gestational diabetes mellitus (GDM). We aimed to study the association between excessive GWG (defined according to Institute of Medicine recommendations) prior to GDM screening, and GDM. Methods We systematically searched four electronic databases from 1990 until September 2014 for observational studies published in English or German that reported an association between excessive GWG and GDM as the outcome. Random effects meta-analyses were performed to provide a pooled estimate of the OR comparing the risk of GDM in women with and without excessive GWG. Results A total of eight studies involving 13,748 participants were included. The pooled analysis of unadjusted OR yielded a summary OR of 1.40 (95% CI 1.21, 1.61; p<0.001) with low between-study heterogeneity (I 2 =16.7%). A sensitivity analysis based on four studies reporting adjusted effect estimates revealed similar results (OR 1.42; 95% CI 1.20, 1.68; p<0.001; I 2 =0%). No evidence was found that the effect of GWG on GDM differs depending on maternal pre-pregnancy BMI category. A funnel plot did not indicate substantial publication bias. Conclusions/interpretation Avoiding excessive weight gain in pregnancy prior to the GDM screening test may be a potential strategy to reduce GDM risk. Meta-analysis registration www.crd.york.ac.uk/PROSPERO CRD42014008802

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Section: Discussioncontrasting

confidence: 51%

Excessive gestational weight gain prior to glucose screening and the risk of gestational diabetes: a meta-analysis

et al. 2015

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“…In the gestational period, the literature focuses on and reports the existence of predisposition to diabetes in obese women (25,35) rather than the independence of the prepregnancy BMI category. Also, in recent years, a relationship has been found between excessive weight gain according to the Institute of Medicine BMI classification for weight gain recommendations and glucose intolerance without actually resulting in the pathology (19).…”

Section: Discussionmentioning

confidence: 99%

Exercise Is Associated with a Reduction in Gestational Diabetes Mellitus

Cordero¹,

Mottola²,

Vargas³

et al. 2015

Medicine &Amp; Science in Sports &Amp; Exercise

126

111

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“…A more recent cohort study also revealed a positive relationship between weight gain in excess of Institute of Medicine guidelines and the development of milder states of glucose intolerance, although these findings were limited to Hispanic women with a BMI of ≥ 35 kg/m 2 . 40 In a clinical trial among obese Danish women, Wolff et al 28 found 20% reductions in serum insulin and leptin levels at 27 weeks of gestation, along with 8% reductions in fasting blood glucose at 36 weeks of gestation, in those women who were assigned randomly to a dietary counseling intervention to restrict weight gain to 6–7 kg in pregnancy. The authors, however, saw no reduction in the risk of incident GDM, which suggests that changes in weight during pregnancy may have a greater impact on more moderate levels of glucose intolerance, which is consistent with our findings.…”

Section: Commentmentioning

confidence: 99%

Weight gain in pregnancy and risk of maternal hyperglycemia

Herring

Oken

Rifas‐Shiman

et al. 2009

American Journal of Obstetrics and Gynecology

118

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OBJECTIVE-The purpose of this study was to examine associations of weight gain from prepregnancy to glycemic screening with glucose tolerance status.STUDY DESIGN-Main outcomes were failed glycemic screening (1-hour glucose result ≥ 140 mg/dL) with either 1 high value on 3-hour oral glucose tolerance testing (impaired glucose tolerance in pregnancy) or ≥ 2 high values on 3-hour oral glucose tolerance testing (gestational diabetes mellitus). We performed multinomial logistic regression to determine the odds of these glucose intolerance outcomes by quartile of gestational weight gain among 1960 women in Project Viva.RESULTS-Mean gestational weight gain was 10.2 ± 4.3 (SD) kg. Compared with the lowest quartile of weight gain, participants in the highest quartile had an increased odds of impaired glucose tolerance in pregnancy (adjusted odds ratio, 2.54; 95% confidence interval, 1.25-5.15), but not gestational diabetes mellitus (odds ratio, 0.93; 95% confidence interval, 0.50-1.70).CONCLUSION-Higher weight gain predicted impaired glucose tolerance in pregnancy, but not gestational diabetes mellitus. NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author ManuscriptGestational diabetes mellitus (GDM) complicates 1-14% of pregnancies 1 and is associated with increased risk of adverse perinatal outcomes 1-5 as well as longer-term complications of obesity and type 2 diabetes mellitus in both mothers and children. 2,3,[6][7][8] Maternal hyperglycemia less severe than that used to define overt diabetes mellitus is also related to perinatal complications. [8][9][10][11][12] These effects may be reduced through treatment. 13 Given the rise in GDM incidence over the past decade, 14 research to identify modifiable determinants of glucose intolerance has become a public health priority.Pregravid obesity is the most well-documented modifiable risk factor for GDM. 15,16 Several studies additionally suggest that the risk of glucose intolerance increases with weight gain just prior to pregnancy. [16][17][18][19] Although the exact mechanisms by which weight gain and obesity promote incident diabetes mellitus are not understood fully, a combination of adiposity-generated insulin resistance and deterioration in pancreatic beta cell function are likely to blame. [20][21][22] Given that fat comprises approximately 30% of weight gain in pregnancy, [23][24][25] during which time women experience physiologic reductions in insulin sensitivity, 26 it seems plausible that greater gestational weight gain would also increase the risk of GDM.Limited data exist regarding the relationship between gestational weight gain and maternal hyperglycemia. Saldana et al 27 found no association between total weight gain and glucose tolerance until the end of the second trimester; however, when the authors analyzed gestational weight gain as a ratio of actual gain compared with recommended gain, they found a modestly increased risk of impaired glucose tolerance (IGT) in pregnancy solely in overweight women, but no association with GDM. A mo...

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The Impact of Gestational Weight Gain and Diet on Abnormal Glucose Tolerance During Pregnancy in Hispanic Women

Cited by 62 publications

References 61 publications

Excessive gestational weight gain prior to glucose screening and the risk of gestational diabetes: a meta-analysis

Excessive gestational weight gain prior to glucose screening and the risk of gestational diabetes: a meta-analysis

Exercise Is Associated with a Reduction in Gestational Diabetes Mellitus

Weight gain in pregnancy and risk of maternal hyperglycemia

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