Trimester-specific patterns of gestational weight gain and their association with adverse pregnancy outcomes in women with gestational diabetes
Overview
This study investigates the relationship between trimester-specific gestational weight gain (GWG) patterns and adverse pregnancy outcomes (APOs) in women with gestational diabetes mellitus (GDM). Findings indicate that excessive GWG before and after the oral glucose tolerance test (OGTT) is linked to increased risks of large for gestational age (LGA) and preeclampsia, respectively, with variations based on pre-pregnancy body mass index (BMI).
Background
Gestational diabetes mellitus (GDM) is a prevalent metabolic disorder during pregnancy, associated with significant risks for both maternal and fetal health. Monitoring gestational weight gain (GWG) is crucial as it correlates with glycemic control and adverse pregnancy outcomes. Understanding the impact of GWG patterns across different trimesters and pre-pregnancy BMI categories can inform better management strategies for women with GDM.
Data Highlights
GWG Timing
Outcome
Adjusted Odds Ratio (aOR)
95% Confidence Interval (CI)
Before OGTT
LGA (Normal-weight)
1.71
1.38–2.13
Before OGTT
LGA (Overweight)
1.72
1.26–2.37
After OGTT
Preeclampsia (Normal-weight)
4.06
2.69–6.12
After OGTT
Preeclampsia (Overweight)
2.49
1.46–4.24
Before OGTT
SGA (Underweight)
0.39
0.25–0.62
Key Findings
Excessive GWG before OGTT is linked to increased LGA risk in normal-weight and overweight women.
Excessive GWG after OGTT is associated with a higher risk of preeclampsia in both normal-weight and overweight women.
Underweight women with excessive GWG before OGTT have a lower risk of SGA.
No significant associations between GWG and APOs were observed in women with obesity.
Nonlinear associations between GWG and APOs were supported by generalized additive models (GAM).
Clinical Implications
Tailoring weight management strategies based on pre-pregnancy BMI and gestational stage may optimize pregnancy outcomes for women with GDM. Clinicians should consider trimester-specific GWG recommendations to mitigate risks of adverse outcomes.
Conclusion
The study presents associations between trimester-specific GWG patterns in managing GDM and adverse pregnancy outcomes across different pre-pregnancy BMI categories.
