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Increasing BMI, waist circumference tied to gestational diabetes
The risk for gestational diabetes is significantly increased in Chinese women whose BMI, measured within 12 weeks of pregnancy, is at least 22.5 kg/m2 and waist circumference at least 78.5 cm, according to recent data.
Xilin Yang, PhD, of the department of epidemiology and biostatistics, School of Public Health, Tianjin Medical University in China, and colleagues evaluated data on 17,803 pregnant women (mean age, 28.5 years; mean waist circumference, 78.8 cm; mean BMI, 22.3 kg/m2) who registered at 4 to 12 weeks’ gestation in Tianjin, China, from 2010 to 2012, to define cutoff points for BMI and waist circumference for the risk for gestational diabetes.
No family history of diabetes was present for 83.6% of participants; 7.8% developed gestational diabetes.
Increasing BMI up to 20 kg/m2 was associated with a slight increase in the risk for gestational diabetes; the risk curve increased more sharply from 22.5 kg/m2 and higher. The risk for gestational diabetes was increased with overweight (OR = 2.84; 95% CI, 2.47-3.26) and subclinical overweight (OR = 1.76; 95% CI, 1.47-2.1) when BMI less than 22.5 kg/m2 was used as the referent.
An increasing waist circumference up to 76 cm was associated with a slight increase in the risk for gestational diabetes and the increase was more steep from 78.5 cm and higher. The risk for gestational diabetes was increased with central obesity (waist circumference 85 cm; OR = 2.58; 95% CI, 2.23-2.98) and subclinical central obesity (waist circumference 78.5 cm to < 80 cm; OR = 1.53; 95% CI, 1.31-1.78) when waist circumference less than 78.5 cm was used as the referent.
The risk for gestational diabetes was further increased when BMI at least 22.5 kg/m2 and waist circumference at least 78.5 cm (OR = 2.83; 95% CI, 1.44-3.28) were present.
“The use of [WHO and Working Group on Obesity in China] global cutoff points to define overweight/obesity remains controversial. ... In this study, the risk of [gestational diabetes] started to rise steeply and linearly from BMI 22.5, a value consistently lower than the recommended cutoff points,” the researchers wrote. “Given the predictive value of central obesity in type 2 diabetes, other researchers have also reported associations between central fat distribution and increased risk of [gestational diabetes] in other populations. ... In our study, we found that value lower than [the Chinese Diabetes Society waist circumference] cutoff point, defined as subclinical central obesity, was already associated with increased risk of [gestational diabetes]. Of note, this cutoff point of 78.5 cm was substantially lower than the recommended values of 82.0 cm in Western pregnant women and 85.5 cm in Indian pregnant women during the first trimester.”– by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.