OBJECTIVE: To estimate whether there is an association between excessive early gestational weight gain and the development of gestational diabetes mellitus (GDM) and excessive fetal growth. METHODS: This is a secondary analysis of a randomized controlled trial of vitamins C and E in nulliparous low-risk women. Maternal weight gain from prepregnancy (self-reported) to 15-18 weeks of gestation was measured, and expected gestational weight gain was determined using the Institute of Medicine 2009 guidelines for each prepregnancy body mass index category. Excessive early gestational weight gain was defined as gestational weight gain greater than the upper range of the Institute of Medicine guidelines. Rates of GDM, birth weight greater than 4,000 g, and large for gestational age (LGA, birth weight 90 percentile or higher) were calculated and compared between women with excessive early gestational weight gain and early nonexcessive gestational weight gain (within or below Institute of Medicine guidelines). RESULTS: A total of 7,985 women were studied. Excessive early gestational weight gain occurred in 47.5% of women. Ninety-three percent of women with excessive early gestational weight gain had total gestational weight gain greater than Institute of Medicine guidelines. In contrast, only 55% of women with nonexcessive early gestational weight gain had total gestational weight gain greater than Institute of Medicine guidelines (P<.001). Rates of GDM, LGA, and birth weight greater than 4,000 g were higher in women with excessive early gestational weight gain. CONCLUSION: In our population, excessive early gestational weight gain occurred in 93% of women who had total gestational weight gain greater than the Institute of Medicine guidelines. In low-risk nulliparous women, excessive early gestational weight gain is associated with the development of GDM and excessive fetal growth. LEVEL OF EVIDENCE: II.
RCT Entities:
OBJECTIVE: To estimate whether there is an association between excessive early gestational weight gain and the development of gestational diabetes mellitus (GDM) and excessive fetal growth. METHODS: This is a secondary analysis of a randomized controlled trial of vitamins C and E in nulliparous low-risk women. Maternal weight gain from prepregnancy (self-reported) to 15-18 weeks of gestation was measured, and expected gestational weight gain was determined using the Institute of Medicine 2009 guidelines for each prepregnancy body mass index category. Excessive early gestational weight gain was defined as gestational weight gain greater than the upper range of the Institute of Medicine guidelines. Rates of GDM, birth weight greater than 4,000 g, and large for gestational age (LGA, birth weight 90 percentile or higher) were calculated and compared between women with excessive early gestational weight gain and early nonexcessive gestational weight gain (within or below Institute of Medicine guidelines). RESULTS: A total of 7,985 women were studied. Excessive early gestational weight gain occurred in 47.5% of women. Ninety-three percent of women with excessive early gestational weight gain had total gestational weight gain greater than Institute of Medicine guidelines. In contrast, only 55% of women with nonexcessive early gestational weight gain had total gestational weight gain greater than Institute of Medicine guidelines (P<.001). Rates of GDM, LGA, and birth weight greater than 4,000 g were higher in women with excessive early gestational weight gain. CONCLUSION: In our population, excessive early gestational weight gain occurred in 93% of women who had total gestational weight gain greater than the Institute of Medicine guidelines. In low-risk nulliparous women, excessive early gestational weight gain is associated with the development of GDM and excessive fetal growth. LEVEL OF EVIDENCE: II.
Authors: Monique M Hedderson; Noel S Weiss; David A Sacks; David J Pettitt; Joe V Selby; Charles P Quesenberry; Assiamira Ferrara Journal: Obstet Gynecol Date: 2006-11 Impact factor: 7.661
Authors: Sharon J Herring; Emily Oken; Sheryl L Rifas-Shiman; Janet W Rich-Edwards; Alison M Stuebe; Ken P Kleinman; Matthew W Gillman Journal: Am J Obstet Gynecol Date: 2009-04-15 Impact factor: 8.661
Authors: Shelly M Asbee; Todd R Jenkins; Jennifer R Butler; John White; Mollie Elliot; Allyson Rutledge Journal: Obstet Gynecol Date: 2009-02 Impact factor: 7.661
Authors: Risa M Hoffman; Caitlin Newhouse; Brian Chu; Jeffrey S A Stringer; Judith S Currier Journal: Curr HIV/AIDS Rep Date: 2021-01-05 Impact factor: 5.071
Authors: J Knabl; C Riedel; J Gmach; R Ensenauer; L Brandlhuber; K M Rasmussen; B Schiessl; R von Kries Journal: J Perinatol Date: 2014-02-27 Impact factor: 2.521
Authors: Tarja I Kinnunen; Christin W Waage; Christine Sommer; Line Sletner; Jani Raitanen; Anne Karen Jenum Journal: Matern Child Health J Date: 2016-07
Authors: Sylvia E Badon; Paige D Wartko; Chunfang Qiu; Tanya K Sorensen; Michelle A Williams; Daniel A Enquobahrie Journal: Med Sci Sports Exerc Date: 2016-06 Impact factor: 5.411