J Clin Endocrinol Metab. 2022 Oct 14:dgac599. doi: 10.1210/clinem/dgac599. Online ahead of print.
ABSTRACT
CONTEXT/OBJECTIVE: To evaluate association of gestational weight gain (GWG) as low, within, or above (excessive) according to Institute of Medicine (IOM) guidelines, with pregnancy outcomes in women with gestational diabetes (GDM) and normal glucose tolerance (NGT).
DESIGN: Prospective cohort study.
SETTING: 7 Belgian hospitals.
PARTICIPANTS: 1843 women receiving universal GDM screening with 75 g oral glucose tolerance test.
MAIN OUTCOME MEASURE: Pregnancy outcomes and postpartum characteristics.
RESULTS: Women with GDM and low GWG (n = 97, 52.4%) had similar rates of small-for-gestational age infants and preterm delivery, were less often overweight or obese postpartum [35.7% (30) vs. 56.5% (26), p < 0.022] and had less often postpartum weight retention (PPWR) [48.8% (41) vs. 87.9% (40), p < 0.001] compared to GWG within range (n = 58, 31.3%). GDM with excessive GWG (n = 30, 16.2%) had more often neonatal hypoglycemia [30.8% (8) vs. 5.9% (3), aOR 7.15, 95% CI (1.52-33.63), p = 0.013] compared to GWG within range. NGT with excessive GWG [28.3% (383)] had more often instrumental delivery [15.9% (61) vs. 11.9% (64), aOR 1.53, 95% CI (1.03-2.27), p = 0.035] and more large-for-gestational age infants [19.3% (74) vs. 10.4% (56), aOR 1.67, 95% CI (1.13-2.47), p = 0.012] compared to GWG within range.
CONCLUSIONS: GWG below IOM guidelines occurred frequently in GDM women, without increased risk for adverse pregnancy outcomes and with better metabolic profile postpartum. Excessive GWG was associated with increased risk for neonatal hypoglycemia and worse metabolic profile postpartum in women with GDM, and with higher rates of LGA and instrumental delivery in NGT women.
PMID:36228141 | DOI:10.1210/clinem/dgac599
