Excessive gestational weight gain in the first trimester is associated with risk of gestational diabetes mellitus: a prospective study from Southwest China. Issue 3 (20th December 2019)

• Record Type: Journal Article
• Authors: Lan, Xi; Zhang, Yi-qi; Dong, Hong-li; Zhang, Ju; Zhou, Feng-ming; Bao, Yan-hong; Zhao, Rong-ping; Cai, Cong-jie; Bai, Dan; Pang, Xin-xin; Zeng, Guo
• Is Part Of: Public health nutrition. Volume 23:Issue 3(2020)
• Page Start: 394
• Page End: 401
• Publication Date: 2019-12-20
• Subjects: Gestational weight gain, -- Gestational diabetes mellitus, -- Pregnancy, -- Optimal ranges, -- China; Nutrition -- Periodicals; Nutrition policy -- Periodicals; Public health -- Periodicals; 613.2
• DOI: 10.1017/S1368980019003513
• Languages: English
• ISSNs: 1368-9800

Abstract

Abstract: Objective: To evaluate the effects of gestational weight gain (GWG) in the first trimester (GWG-F) and the rate of gestational weight gain in the second trimester (RGWG-S) on gestational diabetes mellitus (GDM), exploring the optimal GWG ranges for the avoidance of GDM in Chinese women. Design: A population-based prospective study was conducted. Gestational weight was measured regularly in every antenatal visit and assessed by the Institute of Medicine (IOM) criteria (2009). GDM was assessed with the 75-g, 2-h oral glucose tolerance test at 24–28 weeks of gestation. Multivariable logistic regression was performed to assess the effects of GWG-F and RGWG-S on GDM, stratified by pre-pregnancy BMI. In each BMI category, the GWG values corresponding to the lowest prevalence of GDM were defined as the optimal GWG range. Setting: Southwest China. Participants: Pregnant women ( n 1910) in 2017. Results: After adjusting for confounders, GWG-F above IOM recommendations increased the risk of GDM (OR; 95 % CI) among underweight (2·500; 1·106, 5·655), normal-weight (1·396; 1·023, 1·906) and overweight/obese women (3·017; 1·118, 8·138) compared with women within IOM recommendations. No significant difference was observed between RGWG-S and GDM ( P > 0·05) after adjusting for GWG-F based on the previous model. The optimal GWG-F ranges for the avoidance of GDM were 0·8–1·2, 0·8–1·2 and 0·35–0·70 kg for underweight, normal-weight and overweight/obese women, respectively. Conclusions: Excessive GWG in the first trimester, rather than the second trimester, is associated with increased risk of GDM regardless of pre-pregnancy BMI. Obstetricians should provide more pre-emptive guidance in achieving adequate GWG-F.