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Gestational diabetes risk increases with interpregnancy weight gain
Ehrlich SF. Obstet Gynecol. 2011;doi:10.1097/AOG.0b013e31821aa358.
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Women who gain weight between their first and second pregnancies have a heightened risk for gestational diabetes in the second pregnancy vs. women whose between-pregnancy weight remains stable, researchers have found.
BMI gains of 2 to 2.9 units, or approximately 12 to 17 lb, between the first and second pregnancy were associated with a two times greater likelihood of developing gestational diabetes in the second pregnancy (OR=2.46; 95% CI, 2.00-3.02) compared with no BMI change (± 6 lb), according to results of a new study. Further, a BMI gain of 3 or more units — approximately 18 lb or more — between pregnancies was found to increase the risk for gestational diabetes by more than three times compared with no BMI change (OR=3.40; 95% CI, 2.81-4.12).
The data were based on an analysis of more than 22,000 women at Kaiser Permanente of Northern California during a 10-year period.
This study is the first to examine whether weight loss before a second pregnancy reduces the risk for recurrent gestational diabetes, according to Samantha F. Ehrlich, MPH, and colleagues at Kaiser Permanente of Northern California.
Conversely, weight loss between the first and second pregnancy appears to reduce the risk for gestational diabetes in the second pregnancy. A loss of 2 or more BMI units between pregnancies was associated with a lower risk for gestational diabetes among women who were overweight or obese in their first pregnancy (OR=0.26; 95% CI, 0.14-0.47). Overweight and obese women who had gestational diabetes during the first pregnancy but did not develop it in the second pregnancy tended to gain fewer BMI units compared with women who had recurrent gestational diabetes (mean change, 0.66 vs. 2 units).
“These results suggest that the effects of body mass gains may be greater among women of normal weight in their first pregnancy, whereas the effects of losses in body mass appear greater among overweight or obese women,” Ehrlich said in a press release. “Taken together, the results support the avoidance of gestational weight retention and postpartum weight gain to decrease the risk of gestational diabetes in a second pregnancy, as well as the promotion of weight loss in overweight or obese women, particularly those with a history of gestational diabetes.”
In the study, BMI units were calculated for the average height of the study population (5’4). One BMI unit corresponded to approximately 6 lb.
Disclosure: The researchers report no relevant financial disclosures.
Managing diabetes during pregnancy is only half the battle in our fight against the pandemic of obesity, type 2 diabetes and metabolic syndrome. Pre-pregnancy and interconception health are the foundation for a healthy pregnancy. There has not been enough emphasis on the need to normalize weight during and after pregnancy. This study helps to provide the evidence we need to work towards improved interconception health management.
– Kristin Castorino, DO
Internist and Clinical Research Physician
Sansum Diabetes Research Institute
Disclosure: Dr. Castorino reports no relevant financial disclosures.
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