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Am J Perinatol 2016; 33(13): 1266-1272
DOI: 10.1055/s-0036-1585420
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Characterizing Gestational Weight Gain According to Institute of Medicine Guidelines in Women with Type 1 Diabetes Mellitus: Association with Maternal and Perinatal Outcome

Tetsuya Kawakita
1   Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia
,
Katherine Bowers
2   Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
Ketrell McWhorter
2   Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
3   Division of Epidemiology, Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
,
Barak Rosen
4   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mount Sinai West Hospital, New York, New York
,
Michelle Adams
5   Office for Clinical and Translational Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
Menachem Miodovnik
6   Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland
,
Jane C. Khoury
2   Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
7   Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Publikationsverlauf

26. April 2016

09. Juni 2016

Publikationsdatum:
11. Juli 2016 (online)

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Abstract

Objective This study aims to evaluate the association between gestational weight gain (GWG) defined by the current Institute of Medicine (IOM) guidelines and pregnancy outcomes in women with type 1 diabetes mellitus (DM).

Study design This is a secondary analysis of a cohort of 293 pregnancies of women with type 1 DM between 24 and 41 weeks' gestation. Women were categorized according to GWG per week over the second and third trimester: below, within, and above the IOM guidelines. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated for maternal and neonatal outcomes, controlling for covariates and confounders (referent: GWG within the IOM guidelines).

Results Of the 293 women, there were 49 women (16.7%) with the GWG below the IOM guidelines, 86 women (29.4%) with the GWG within the IOM guidelines, and 158 women (53.9%) with the GWG above the IOM guidelines. Women with the GWG above the IOM guidelines had a higher risk of macrosomia and neonatal hyperbilirubinemia (aOR: 2.78; 95% CI: 1.23–6.30 and 2.31; 1.22–4.35, respectively).

Conclusion GWG above the IOM guidelines is associated with an increased risk of macrosomia and neonatal hyperbilirubinemia. Maintaining GWG within the IOM guidelines may decrease the risk of excessive fetal growth and neonatal hyperbilirubinemia in infants of women with type 1 DM.

Keywords

gestational weight gain - neonatal hyperbilirubinemia - Institute of Medicine guidelines - macrosomia - type 1 diabetes

Note

The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.


 

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