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Interpregnancy weight change and recurrence of gestational diabetes mellitus: a population‐based cohort study
Author(s) -
Sorbye LM,
Cnattingius S,
Skjaerven R,
Klungsoyr K,
Wikström AK,
Kvalvik LG,
Morken NH
Publication year - 2020
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.16364
Subject(s) - medicine , gestational diabetes , overweight , obstetrics , pregnancy , relative risk , population , body mass index , weight gain , gynecology , confounding , cohort study , obesity , gestation , body weight , confidence interval , environmental health , genetics , biology
Objective To estimate recurrence risk of gestational diabetes mellitus (GDM) by interpregnancy weight change. Design Population‐based cohort study. Setting and population Data from the Swedish (1992–2010) and the Norwegian (2006–2014) Medical Birth Registries on 2763 women with GDM in first pregnancy, registered with their first two singleton births and available information on height and weight. Methods Interpregnancy weight change (BMI in second pregnancy minus BMI in first pregnancy) was categorised in six groups by BMI units. Relative risks (RRs) of GDM recurrence were obtained by general linear models for the binary family and adjusted for confounders. Analyses were stratified by BMI in first pregnancy (<25 and ≥25 kg/m 2 ). Main outcome measure GDM in second pregnancy. Results Among overweight/obese women (BMI ≥25), recurrence risk of GDM decreased in women who reduced their BMI by 1–2 units (relative risk [RR] 0.80, 95% CI 0.65–0.99) and >2 units (RR 0.72, 95% CI 0.59–0.89) and increased if BMI increased by ≥4 units (RR 1.26, 95% CI 1.05–1.51) compared wth women with stable BMI (−1 to 1 units). In normal weight women (BMI <25), risk of GDM recurrence increased if BMI increased by 2–4 units (RR 1.32, 95% CI 1.08–1.60) and ≥4 units (RR 1.61, 95% CI 1.28–2.02) compared with women with stable BMI. Conclusion Interpregnancy weight loss reduced risk of GDM recurrence in overweight/obese women. Weight gain between pregnancies increased recurrence risk for GDM in both normal and overweight/obese women. Our findings highlight the importance of weight management in the interconception window in women with a history of GDM. Tweetable abstract Interpregnancy weight loss reduces recurrence of gestational diabetes mellitus in overweight/obese women.