HIGH RATE WEIGHT GAIN AND DEVELOPMENT OF GESTATIONAL DIABETES
Rozhan Y. Khalil a, Maida Y. Shamdeen b, and Raz T. Omer c
a Department of Gynecology and Obstetrics, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
b Department of Obstetrics and Gynecology, College of Medicine, University of Duhok. Kurdistan Region, Iraq.
c KBMS Trainee, Sulaimani Maternity Teaching Hospital, Kurdistan Region, Iraq.
Submitted: 17/5/2019; Accepted: 29/10/2019; Published: 21/12/2019
DOI Link: https://doi.org/10.17656/jsmc.10222
Excessive gestational weight gain and gestational diabetes mellitus (GDM) significantly increase morbidity and mortality for both the mother and the fetus.
To assess maternal weight gain at 28 weeks of gestation in women developing GDM compared with pregnant women without GDM.
Patients and Methods
This study is a case-control study of weight gain in pregnant women at 28 weeks of gestation. Data analysis of weight gain was obtained in 225 pregnant women (75 cases of GDM and 150 pregnant women without GDM-controls).
Two hundred twenty-five women (GDM group of 75 women and 150 control pregnant women) were evaluated. Demographics characteristics of both groups (case-controls) were compatible. There was a significant difference between mean weight gain among GDM groups (17.36 ±2.89) in comparison to mean weight gain in controls groups (15.67± 2.34) giving a P-value =0.001. Furthermore, we subdivided the rate of weight gain into three categories: pregnant women who gained weight 0-10kg, 10-20, and above 20kg. There was a significant difference according to these categories, 25.3% of women with GDM had an increase of weight of more than 20 kg while only 7.3% of women without GDM increased their weight more than 20kg making P-value=0.001.
Weight gain is higher in women diagnosed with GDM at 28 weeks of gestation in comparison to women without GDM.
Gestational weight gain, Gestational diabetes mellitus.
1. Pitkin RM. Nutritional support in obstetrics and gynecology. Clin Obstet Gynecol. 1976;19(3):489–513.
2. Marathe PH, Gao HX, Close KL. American Diabetes Association Standards of Medical Care in Diabetes 2017. J Diabetes. 2017;9(4):320–4.
3. Whitaker RC, Pepe MS, Seidel KD, Wright JA, Knopp RH. Gestational diabetes and the risk of offspring obesity. Pediatrics. 1998;101(2):e9–e9.
4. Reaven GM. Role of insulin resistance in human disease. Diabetes. 1988;37(12):1595–607.
5. Rondinone CM. Adipocyte-derived hormones, cytokines, and mediators. Endocrine. 2006; 29(1):81–90.
6. Catalano PM, Tyzbir ED, Wolfe RR, Calles J, Roman NM, Amini SB, et al. Carbohydrate metabolism during pregnancy in control subjects and women with gestational diabetes. Am J Physiol Metab. 1993;264(1):E60–7.
7. Canada and management of diabetes. Important differences: Canadian Diabetes Association 2008 clinical practice guidelines and the consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia. 2009;52(3):552–3.
8. Butte NF, Wong WW, Treuth MS, Ellis KJ, O’Brian Smith E. Energy requirements during pregnancy based on total energy expenditure and energy deposition. Am J Clin Nutr. 2004;79(6):1078–87.
9. Thomas DM, Navarro-Barrientos JE, Rivera DE, Heymsfield SB, Bredlau C, Redman LM, et al. Dynamic energy-balance model predicting gestational weight gain. Am J Clin Nutr. 2011;95(1):115–22.
10. Langford A, Joshu C, Chang JJ, Myles T, Leet T. Does gestational weight gain affect the risk of adverse maternal and infant outcomes in overweight women? Matern Child Health J. 2011;15(7):860–5.
11. Hedderson MM, Gunderson EP, Ferrara A. Gestational weight gain and risk of gestational diabetes mellitus. Obstet Gynecol. 2010;115(3):597.
12. Branum AM, Sharma AJ, Deputy NP. Gestational Weight Gain Among Women with Full-Term, Singleton Births, Compared with Recommendations-48 States and the District of Columbia, 2015. CENTERS DISEASE CONTROL 1600 CLIFTON RD, ATLANTA, GA 30333 USA; 2016.
13. Abrams B, Selvin S. Maternal weight gain pattern and birth weight. Obstet Gynecol. 1995;86(2):163–9.
14. Solomon CG, Willett WC, Carey VJ, Rich-Edwards J, Hunter DJ, Colditz GA, et al. A prospective study of pregravid determinants of gestational diabetes mellitus. Jama. 1997;278(13):1078–83.
15. Catalano PM, Huston L, Amini SB, Kalhan SC. Longitudinal changes in glucose metabolism during pregnancy in obese women with normal glucose tolerance and gestational diabetes mellitus. Am J Obstet Gynecol. 1999;180(4):903–16.
16. Gibson KS, Waters TP, Catalano PM. Maternal weight gain in women who develop gestational diabetes mellitus. Obstet Gynecol. 2012;119(3):560–5.
17. Saldana TM, Siega-Riz AM, Adair LS, Suchindran C. The relationship between pregnancy weight gain and glucose tolerance status among black and white women in central North Carolina. Am J Obstet Gynecol. 2006;195(6):1629–35.
18. Kabiru W, Raynor BD. Obstetric outcomes associated with an increase in BMI category during pregnancy. Am J Obstet Gynecol. 2004;191(3):928–32.
19. Tovar A, Must A, Bermudez OI, Hyatt RR, Chasan-Taber L. The impact of gestational weight gain and diet on abnormal glucose tolerance during pregnancy in Hispanic women. Matern Child Health J. 2009;13(4):520–30.
20. Herring SJ, Oken E, Rifas-Shiman SL, Rich-Edwards JW, Stuebe AM, Kleinman KP, et al. Weight gain in pregnancy and risk of maternal hyperglycemia. Am J Obstet Gynecol. 2009;201(1):61-e1.
21. Far MA, Ziaei S, Kazemnejad A. The impact of maternal age, pre-pregnancy body mass index, weight gain and parity on glucose challenge test (GCT). Int J Fertil Steril. 2012;5(4):207.
22. MacDonald SC, Bodnar LM, Himes KP, Hutcheon JA. Patterns of Gestational Weight Gain in Early Pregnancy and Risk of Gestational Diabetes Mellitus. Epidemiology [Internet]. 2017 May;28(3):419–27. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28151742
23. Kieffer EC, Carman WJ, Gillespie BW, Nolan GH, Worley SE, Guzman JR. Obesity and gestational diabetes among African-American women and Latinas in Detroit: implications for disparities in women’s health. J Am Med Womens Assoc. 2001;56(4):181–7.
24. Hackmon R, James R, Green CO, Ferber A, Barnhard Y, Divon M. The impact of maternal age, body mass index and maternal weight gain on the glucose challenge test in pregnancy. J Matern Neonatal Med. 2007;20(3):253–7.
25. Brennand EA, Dannembaum D, Willows ND. Pregnancy outcomes of First Nations women in relation to pregravid weight and pregnancy weight gain. J Obstet Gynaecol Canada. 2005;27(10):936–44.
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