Pregnancy weight gain may increase gestational diabetes risk

Increased gestational weight gain, particularly during the first trimester, was associated with a 50% increased risk for gestational diabetes and was more pronounced for overweight, nonwhite women, according to new data.

A nested, case-control study included 345 women with gestational diabetes and 800 matched controls who delivered a baby between 1996 and 1998. Researchers assessed the overall rate for gestational weight gain until gestational diabetes screening (typically between 24 and 28 weeks’ gestation) and trimester-specific rates of weight gain in comparison with the 2009 Institute of Medicine guidelines for recommended pregnancy weight gain.

Women with gestational diabetes were more likely to be aged 35 years and older, nonwhite, overweight or obese before pregnancy, and have a family history of diabetes, hypertension at first prenatal visit and two or more prior live births.

The association with gestational diabetes was primarily associated with increased weight gain during the first trimester. The association was even stronger for nonwhite, overweight and obese women.

Compared with the lowest tertile of gestational weight gain (<0.60 lb per week), a rate of gestational weight gain from 0.60 lb to 0.88 lb per week (OR=1.43; 95% CI, 0.96-2.14) and 0.89 lb or more per week (OR=1.74; 95% CI, 1.16-2.6) was associated with increased risk for gestational diabetes.

“Health care providers should talk to their patients early in their pregnancy about the appropriate gestational weight gain, especially during the first trimester, and help women monitor their weight gain,” Monique Hedderson, PhD, researcher at the Kaiser Permanente Division of Research, Oakland, Calif., said in a press release.

Hedderson MM. Obstet Gynecol. 2010;115:597–604.