Excessive early gestational weight gain and risk of gestational diabetes mellitus in nulliparous women

Authors

Carlos A. Carreno, University of Texas Health Science Center at Houston
Rebecca G. Clifton, University of Texas Health Science Center at Houston
John C. Hauth, University of Texas Health Science Center at Houston
Leslie Myatt, University of Texas Health Science Center at Houston
James M. Roberts, University of Texas Health Science Center at Houston
Catherine Y. Spong, University of Texas Health Science Center at Houston
Michael W. Varner, University of Texas Health Science Center at Houston
John M. Thorp, University of Texas Health Science Center at Houston
Brian M. Mercer, University of Texas Health Science Center at Houston
Alan M. Peaceman, University of Texas Health Science Center at Houston
Susan M. Ramin, University of Texas Health Science Center at Houston
Marshall W. Carpenter, University of Texas Health Science Center at Houston
Anthony Sciscione, University of Texas Health Science Center at Houston
Jorge E. Tolosa, University of Texas Health Science Center at Houston
Yoram Sorokin, University of Texas Health Science Center at Houston

Document Type

Journal Article

Publication Date

6-1-2012

Journal

Obstetrics and Gynecology

Volume

119

Issue

6

DOI

10.1097/AOG.0b013e318256cf1a

Abstract

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. © 2012 by The American College of Obstetricians and Gynecologists. Published by Lippincott Williams & Wilkins.

APA Citation

Carreno, C., Clifton, R., Hauth, J., Myatt, L., Roberts, J., Spong, C., Varner, M., Thorp, J., Mercer, B., Peaceman, A., Ramin, S., Carpenter, M., Sciscione, A., Tolosa, J., & Sorokin, Y. (2012). Excessive early gestational weight gain and risk of gestational diabetes mellitus in nulliparous women. Obstetrics and Gynecology, 119 (6). http://dx.doi.org/10.1097/AOG.0b013e318256cf1a