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Fetal growth in relation to gestational weight gain in women with Type 2 diabetes: an observational study
Author(s) -
Parellada C. B.,
Ásbjörnsdóttir B.,
Ringholm L.,
Damm P.,
Mathiesen E. R.
Publication year - 2014
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12558
Subject(s) - medicine , weight gain , overweight , gestational diabetes , pregnancy , obstetrics , birth weight , gestational age , gestation , type 2 diabetes , body mass index , diabetes mellitus , endocrinology , body weight , biology , genetics
Abstract Aims To evaluate fetal growth in relation to gestational weight gain in women with Type 2 diabetes. Methods A retrospective cohort study of 142 consecutive pregnancies in 28 women of normal weight, 39 overweight women and 75 obese women with Type 2 diabetes (pre‐pregnancy BMI < 25, 25–29.9, ≥ 30 kg/m 2 , respectively). Gestational weight gain was categorized as excessive (exceeding the US Institute of Medicine recommendations) or as non‐excessive (within or below the Institute of Medicine recommendations). Results Excessive and non‐excessive gestational weight gain were seen in 61 (43%) and 81 women (57%) with a median (range) gestational weight gain of 14.3 (9–32) vs 7.0 (−5–16) kg ( P < 0.001), respectively. Infants of women with excessive gestational weight gain were characterized by higher birth weight (3712 vs 3258 g; P = 0.001), birth weight z‐score (1.14 vs ‐0.01, P = 0.001) and prevalence of large‐for‐gestational‐age infants (48 vs 20%; P < 0.001). In normal weight, overweight and obese women with non‐excessive gestational weight gain, the median weight gain in the first half of pregnancy was 371, 114 and 81 g/week, and in the second half of pregnancy 483, 427 and 439 g/week, respectively. In multiple linear regression analysis, gestational weight gain was associated with a higher infant birth weight z‐score independent of pre‐pregnancy BMI , smoking, HbA 1c and insulin dose at last visit, ethnicity and parity [β=0.1 (95% CI 0.06–0.14), P < 0.001]. Conclusions Infant birth weight was almost 0.5 kg higher in women with Type 2 diabetes and excessive gestational weight gain than in women with Type 2 diabetes and non‐excessive weight gain.