August 10, 2017
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Healthy diet, ideal prepregnancy weight lower risk for gestational diabetes

South Asian women who achieve optimal prepregnancy weight and improve their diet quality may have a lower risk for gestational diabetes compared with women who do not, according to findings published in CMAJ Open.

Sonia S. Anand, MD, professor of medicine at Michael G. DeGroote School of Medicine and senior scientist at the Population Health Research Institute of Hamilton Health Sciences at McMaster University in Hamilton, Ontario, and colleagues evaluated data from the South Asian Birth Cohort (START) on 1,006 South Asian women from Canada with singleton pregnancies in the second trimester of pregnancy between July 11, 2011, and Nov. 10, 2015, to determine the risks for gestational diabetes and its effect on newborn health.

Overall, 36.3% of participants developed gestational diabetes, and data were available for 98.3% of newborns.

Participants with gestational diabetes were older (P < .001), and were more likely to have a family history of diabetes (P < .001), be multiparous (P < .001), have a higher prepregnancy weight (P < .001), be shorter (P = .02), have a higher prepregnancy BMI (P < .001), have more body fat (P < .001) and consume a low-quality diet (P < .001) compared with participants without gestational diabetes.

The risk for gestational diabetes was independently associated with maternal age (per 1-year increase, OR = 1.08; 95% CI, 1.04-1.12), family history of diabetes (OR = 1.65; 95% CI, 1.26-2.17), prepregnancy weight (per 1-kg increase, OR = 1.025; 95% CI, 1.01-1.04) and low diet quality (OR = 1.57; 95% CI, 1.16-2.12). Maternal height was the only protective factor against gestational diabetes (per 1-cm increase, OR = 0.97; 95% CI, 1.95-0.99).

Infants of participants with gestational diabetes had higher birth weight (P = .005), ponderal index (P = .002), skinfold thickness (P = .007) and lower insulin sensitivity compared with infants of participants without gestational diabetes.

“To our knowledge, such messaging regarding prepregnancy weight and diet quality is not routinely provided by primary care physicians or public health specialists, and requires an integrated approach involving primary health-care sector and policy initiatives,” Anand said in a press release. “Intervention studies are needed to determine if lowering prepregnancy weight and optimizing diet quality during pregnancy can reduce the high rates of gestational diabetes in this high-risk population.” – by Amber Cox

Disclosures: The authors report no relevant financial disclosures.