Fetal growth in relation to gestational weight gain in women with Type 2 diabetes: an observational study
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, ≥ 3...
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| Published in: | Diabetic medicine Vol. 31; no. 12; pp. 1681 - 1689 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Oxford
Blackwell Publishing Ltd
01-12-2014
Blackwell Wiley Subscription Services, Inc BlackWell Publishing Ltd |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | 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/m2, 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, HbA1c 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.
What's new?
In women with Type 2 diabetes, the impact of excessive gestational weight gain according to the Institute of Medicine's guidelines on fetal outcome was evaluated.
Infant birth weight was almost 0.5 kg higher and neonatal morbidity more prevalent in women with excessive compared with non‐excessive weight gain.
Total gestational weight gain was an independent predictor of excessive fetal growth, regardless of pre‐pregnancy BMI and glycaemic control during pregnancy.
The observed weekly gestational weight gain in early and late pregnancy resulting in appropriate total weight gain is given for normal weight, overweight and obese women, respectively. |
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| Bibliography: | ark:/67375/WNG-LC43XW83-L ArticleID:DME12558 istex:0D9206576A8EA4174E4BFB1F9ED9D0ECA647D666 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2 |
| ISSN: | 0742-3071 1464-5491 |
| DOI: | 10.1111/dme.12558 |