Gestational weight gain and gestational diabetes mellitus: Perinatal outcomes

Yvonne W. Cheng, Judith H. Chung, Ingrid Kurbisch-Block, Maribeth Inturrisi, Sherri Shafer, Aaron Caughey

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

OBJECTIVE: To examine the association between gestational weight gain and perinatal outcome in women with gestational diabetes mellitus (GDM). METHODS: This is a retrospective cohort study of women with nonanomalous singleton pregnancies with GDM enrolled in the Sweet Success California Diabetes and Pregnancy Program between 2001 and 2004. Gestational weight gain, calculated from prepregnancy weight and weight at last prenatal Sweet Success visit, was subgrouped into below, within, and above the Institute of Medicine (IOM) weight-gain guidelines. Perinatal outcomes were examined using χ test and multivariable regression analysis with 15-35-lb weight gain as the reference group. RESULTS: There were 31,074 women meeting study criteria. Compared with women with gestational weight gain within the IOM guidelines, women who gained above the guidelines had higher odds of having large for gestational age neonates (adjusted odds ratio [aOR] 1.72, 95% confidence interval [CI] 1.53-1.93, number needed to harm 10), preterm delivery (aOR 1.30, 95% CI 1.14-1.48, number needed to harm 32), and primary cesarean delivery (aOR 1.52, 95% CI 1.26-1.83, number needed to harm 10). Women who gained below the guidelines had higher odds of having small for gestational age neonates (aOR 1.39, 95% CI 1.01-1.90) and maintaining diet-controlled GDM (aOR 1.47, 95% CI 1.34-1.63) and lower odds of having large for gestational age neonates (aOR 0.60, 95% CI 0.52-0.67). CONCLUSION: Women diagnosed with GDM who had gestational weight gain above the IOM guidelines have higher risk of undesirable outcomes, including preterm delivery, having macrosomic neonates, and cesarean delivery. Women who gained below guidelines are more likely to remain on diet control but have small for gestational age neonates.

Original languageEnglish (US)
Pages (from-to)1015-1022
Number of pages8
JournalObstetrics and Gynecology
Volume112
Issue number5
DOIs
StatePublished - Nov 2008
Externally publishedYes

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Gestational Diabetes
Weight Gain
Odds Ratio
Guidelines
Confidence Intervals
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Gestational Age
Newborn Infant
Diet
Weights and Measures
Pregnancy
Cohort Studies
Retrospective Studies
Regression Analysis

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Gestational weight gain and gestational diabetes mellitus : Perinatal outcomes. / Cheng, Yvonne W.; Chung, Judith H.; Kurbisch-Block, Ingrid; Inturrisi, Maribeth; Shafer, Sherri; Caughey, Aaron.

In: Obstetrics and Gynecology, Vol. 112, No. 5, 11.2008, p. 1015-1022.

Research output: Contribution to journalArticle

Cheng, YW, Chung, JH, Kurbisch-Block, I, Inturrisi, M, Shafer, S & Caughey, A 2008, 'Gestational weight gain and gestational diabetes mellitus: Perinatal outcomes', Obstetrics and Gynecology, vol. 112, no. 5, pp. 1015-1022. https://doi.org/10.1097/AOG.0b013e31818b5dd9
Cheng, Yvonne W. ; Chung, Judith H. ; Kurbisch-Block, Ingrid ; Inturrisi, Maribeth ; Shafer, Sherri ; Caughey, Aaron. / Gestational weight gain and gestational diabetes mellitus : Perinatal outcomes. In: Obstetrics and Gynecology. 2008 ; Vol. 112, No. 5. pp. 1015-1022.
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abstract = "OBJECTIVE: To examine the association between gestational weight gain and perinatal outcome in women with gestational diabetes mellitus (GDM). METHODS: This is a retrospective cohort study of women with nonanomalous singleton pregnancies with GDM enrolled in the Sweet Success California Diabetes and Pregnancy Program between 2001 and 2004. Gestational weight gain, calculated from prepregnancy weight and weight at last prenatal Sweet Success visit, was subgrouped into below, within, and above the Institute of Medicine (IOM) weight-gain guidelines. Perinatal outcomes were examined using χ test and multivariable regression analysis with 15-35-lb weight gain as the reference group. RESULTS: There were 31,074 women meeting study criteria. Compared with women with gestational weight gain within the IOM guidelines, women who gained above the guidelines had higher odds of having large for gestational age neonates (adjusted odds ratio [aOR] 1.72, 95{\%} confidence interval [CI] 1.53-1.93, number needed to harm 10), preterm delivery (aOR 1.30, 95{\%} CI 1.14-1.48, number needed to harm 32), and primary cesarean delivery (aOR 1.52, 95{\%} CI 1.26-1.83, number needed to harm 10). Women who gained below the guidelines had higher odds of having small for gestational age neonates (aOR 1.39, 95{\%} CI 1.01-1.90) and maintaining diet-controlled GDM (aOR 1.47, 95{\%} CI 1.34-1.63) and lower odds of having large for gestational age neonates (aOR 0.60, 95{\%} CI 0.52-0.67). CONCLUSION: Women diagnosed with GDM who had gestational weight gain above the IOM guidelines have higher risk of undesirable outcomes, including preterm delivery, having macrosomic neonates, and cesarean delivery. Women who gained below guidelines are more likely to remain on diet control but have small for gestational age neonates.",
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AB - OBJECTIVE: To examine the association between gestational weight gain and perinatal outcome in women with gestational diabetes mellitus (GDM). METHODS: This is a retrospective cohort study of women with nonanomalous singleton pregnancies with GDM enrolled in the Sweet Success California Diabetes and Pregnancy Program between 2001 and 2004. Gestational weight gain, calculated from prepregnancy weight and weight at last prenatal Sweet Success visit, was subgrouped into below, within, and above the Institute of Medicine (IOM) weight-gain guidelines. Perinatal outcomes were examined using χ test and multivariable regression analysis with 15-35-lb weight gain as the reference group. RESULTS: There were 31,074 women meeting study criteria. Compared with women with gestational weight gain within the IOM guidelines, women who gained above the guidelines had higher odds of having large for gestational age neonates (adjusted odds ratio [aOR] 1.72, 95% confidence interval [CI] 1.53-1.93, number needed to harm 10), preterm delivery (aOR 1.30, 95% CI 1.14-1.48, number needed to harm 32), and primary cesarean delivery (aOR 1.52, 95% CI 1.26-1.83, number needed to harm 10). Women who gained below the guidelines had higher odds of having small for gestational age neonates (aOR 1.39, 95% CI 1.01-1.90) and maintaining diet-controlled GDM (aOR 1.47, 95% CI 1.34-1.63) and lower odds of having large for gestational age neonates (aOR 0.60, 95% CI 0.52-0.67). CONCLUSION: Women diagnosed with GDM who had gestational weight gain above the IOM guidelines have higher risk of undesirable outcomes, including preterm delivery, having macrosomic neonates, and cesarean delivery. Women who gained below guidelines are more likely to remain on diet control but have small for gestational age neonates.

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