Excessive Gestational Weight Gain in Women with Gestational and Pregestational Diabetes

ABSTRACT

We sought to determine the frequency of excessive gestational weight gain (GWG) and its impact on perinatal outcomes in women with gestational (GDM) and pregestational diabetes mellitus (DM). A retrospective cohort of diabetic women was studied. GWG was categorized by the 2009 Institute of Medicine guidelines. Perinatal outcomes were compared between those women with and without excessive GWG. There were 153 women who met study criteria. There was no difference in excessive GWG between women with GDM and pregestational DM (44.4% versus 38.5%, p = 0.51) or based on White's class (p = 0.17). After adjusting for confounders, excessive GWG was not associated with an increased rate of adverse perinatal outcomes (odds ratio 1.49, 95% confidence interval 0.56 to 2.35) and had similar associations with both pregestational DM and GDM. Although excessive GWG was common in our diabetic population, it was not associated with an increased rate of adverse perinatal outcomes.

KEYWORDS

Gestational diabetes - pregestational diabetes - adverse outcomes - gestational weight gain - excessive gestational weight gain - Institute of Medicine

REFERENCES

• 1 Rasmussen K M, Yaktine A L. Weight Gain During Pregnancy: Reexamining the Guidelines. Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines. Washington, DC: National Academies Press; 2009
• 2 Cormier C M, Martinez C A, Refuerzo J S et al.. White's classification of diabetes in pregnancy in the 21st century: is it still valid?.  Am J Perinatol. 2010;  27 349-352
• 3 ACOG Committee on Practice Bulletins—Obstetrics . ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002.  Obstet Gynecol. 2002;  99 159-167
• 4 American College of Obstetricians and Gynecologists Committee on Practice Bulletins—Obstetrics . ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologists. Number 30, September 2001 (replaces Technical Bulletin Number 200, December 1994). Gestational diabetes.  Obstet Gynecol. 2001;  98 525-538
• 5 ACOG Committee on Practice Bulletins . ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists. Number 60, March 2005. Pregestational diabetes mellitus.  Obstet Gynecol. 2005;  105 675-685
• 6 White P. Classification of obstetric diabetes.  Am J Obstet Gynecol. 1978;  130 228-230
• 7 Catalano P M, Roman N M, Tyzbir E D, Merritt A O, Driscoll P, Amini S B. Weight gain in women with gestational diabetes.  Obstet Gynecol. 1993;  81 523-528
• 8 Walker L O, Hoke M M, Brown A. Risk factors for excessive or inadequate gestational weight gain among Hispanic women in a U.S.-Mexico border state.  J Obstet Gynecol Neonatal Nurs. 2009;  38 418-429
• 9 Brawarsky P, Stotland N E, Jackson R A et al.. Pre-pregnancy and pregnancy-related factors and the risk of excessive or inadequate gestational weight gain.  Int J Gynaecol Obstet. 2005;  91 125-131
• 10 Cheng Y W, Chung J H, Kurbisch-Block I, Inturrisi M, Shafer S, Caughey A B. Gestational weight gain and gestational diabetes mellitus: perinatal outcomes.  Obstet Gynecol. 2008;  112 1015-1022