Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes
Background: Pregestational excessive body mass index (BMI) is linked to an increased risk for gestational diabetes mellitus (GDM), but less is known on the effect of adolescent BMI on GDM occurrence. The study aimed to investigate possible associations of adolescent BMI and changes in BMI experience...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-12-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537021004922 |
| _version_ | 1818994513153097728 |
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| author | Gabriel Chodick Maayan Omer-Gilon Estela Derazne Gal Puris Ran Rotem Dorit Tzur Orit Pinhas-Hamiel Tali Cukierman-Yaffe Avi Shina Inbar Zucker Amir Tirosh Arnon Afek Varda Shalev Gilad Twig |
| author_facet | Gabriel Chodick Maayan Omer-Gilon Estela Derazne Gal Puris Ran Rotem Dorit Tzur Orit Pinhas-Hamiel Tali Cukierman-Yaffe Avi Shina Inbar Zucker Amir Tirosh Arnon Afek Varda Shalev Gilad Twig |
| author_sort | Gabriel Chodick |
| collection | DOAJ |
| description | Background: Pregestational excessive body mass index (BMI) is linked to an increased risk for gestational diabetes mellitus (GDM), but less is known on the effect of adolescent BMI on GDM occurrence. The study aimed to investigate possible associations of adolescent BMI and changes in BMI experienced before first pregnancy, with gestational diabetes risk. Methods: This retrospective study was based on linkage of a military screening database of adolescent health status (Israel Defence Forces) including measured height and weight, with medical records (Maccabi Healthcare Services, MHS) of a state-mandated health provider. The latter covers about 25% of the Israeli population; about 90% of pregnant women undergo screening by the two-step Carpenter-Coustan method. Adolescent BMI was categorized according to Center of Disease Control and Prevention percentiles. Only first documented pregnanies were analyzed and GDM was the outcome. Findings: Of 190,905 nulliparous women, 10,265 (5.4%) developed GDM. Incidence proportions of GDM were 5.1%, 6.1%, 7.3%, and 8.9% among women with adolescent normal BMI, underweight, overweight, and obesity (p<0.001), respectively. In models that accounted for age at pregnancy, birth year, and sociodemographic variables, the adjusted odd ratios (aORs) for developing GDM were: 1.2 (95%CI, 1.1-1.3), 1.5 (1.4-1.6), and 1.9 (1.7-2.1) for adolescent underweight, overweight, and obesity (reference group, normal BMI). Adolescent BMI tracked with BMI notes in the pre-pregnancy period (r=63%). Resuming normal pre-pregnancy BMI from overweight or obesity in adolescence diminished GDM risk, but this diminished risk was not observed among those who returned to a normal per-pre-pregnancy BMI from being underweight in adolescence. Sustained overweight or obesity conferred an aOR for developing GDM of 2.5 (2.2-2.7); weight gain from adolescent underweight and normal BMI to pre-pregnancy excessive BMI conferred aORs of 3.1 (1.6-6.2) and 2.6 (2.2-2.7), respectively. Interpretation: Change in BMI status from adolescence to pre-pregnancy may contribute to GDM risk. Identifying at-risk populations is important for early preventive interventions. Funding: None. |
| first_indexed | 2024-12-20T20:59:08Z |
| format | Article |
| id | doaj.art-7fe3a86da8344ada99f358855b3aca12 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-12-20T20:59:08Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-7fe3a86da8344ada99f358855b3aca122022-12-21T19:26:46ZengElsevierEClinicalMedicine2589-53702021-12-0142101211Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetesGabriel Chodick0Maayan Omer-Gilon1Estela Derazne2Gal Puris3Ran Rotem4Dorit Tzur5Orit Pinhas-Hamiel6Tali Cukierman-Yaffe7Avi Shina8Inbar Zucker9Amir Tirosh10Arnon Afek11Varda Shalev12Gilad Twig13Maccabitech Research Institute, Maccabi Healthcare Services, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Corresponding Authors: Gabriel Chodick, PhD, Maccabitech Research Institute, Maccabi Healthcare Services, Tel Aviv, IsraelDepartment of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, IsraelMaccabitech Research Institute, Maccabi Healthcare Services, Tel Aviv, Israel; Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, MADepartment of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Ramat Gan, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Chaim Sheba Medical Center at Tel Hashomer, Ramat Gan, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Israeli Ministry of Health, Jerusalem, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Chaim Sheba Medical Center at Tel Hashomer, Ramat Gan, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Central Management, Sheba Medical Center, Tel Hashomer, Ramat Gan, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel; Chaim Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel; Co-Corresponding Authors: Gilad Twig, M.D., MPH, Ph.D., Academy and Research Division, Surgeon General Headquarters, Israel Defense Forces, Ramat-Gan, IsraelBackground: Pregestational excessive body mass index (BMI) is linked to an increased risk for gestational diabetes mellitus (GDM), but less is known on the effect of adolescent BMI on GDM occurrence. The study aimed to investigate possible associations of adolescent BMI and changes in BMI experienced before first pregnancy, with gestational diabetes risk. Methods: This retrospective study was based on linkage of a military screening database of adolescent health status (Israel Defence Forces) including measured height and weight, with medical records (Maccabi Healthcare Services, MHS) of a state-mandated health provider. The latter covers about 25% of the Israeli population; about 90% of pregnant women undergo screening by the two-step Carpenter-Coustan method. Adolescent BMI was categorized according to Center of Disease Control and Prevention percentiles. Only first documented pregnanies were analyzed and GDM was the outcome. Findings: Of 190,905 nulliparous women, 10,265 (5.4%) developed GDM. Incidence proportions of GDM were 5.1%, 6.1%, 7.3%, and 8.9% among women with adolescent normal BMI, underweight, overweight, and obesity (p<0.001), respectively. In models that accounted for age at pregnancy, birth year, and sociodemographic variables, the adjusted odd ratios (aORs) for developing GDM were: 1.2 (95%CI, 1.1-1.3), 1.5 (1.4-1.6), and 1.9 (1.7-2.1) for adolescent underweight, overweight, and obesity (reference group, normal BMI). Adolescent BMI tracked with BMI notes in the pre-pregnancy period (r=63%). Resuming normal pre-pregnancy BMI from overweight or obesity in adolescence diminished GDM risk, but this diminished risk was not observed among those who returned to a normal per-pre-pregnancy BMI from being underweight in adolescence. Sustained overweight or obesity conferred an aOR for developing GDM of 2.5 (2.2-2.7); weight gain from adolescent underweight and normal BMI to pre-pregnancy excessive BMI conferred aORs of 3.1 (1.6-6.2) and 2.6 (2.2-2.7), respectively. Interpretation: Change in BMI status from adolescence to pre-pregnancy may contribute to GDM risk. Identifying at-risk populations is important for early preventive interventions. Funding: None.http://www.sciencedirect.com/science/article/pii/S2589537021004922gestationaldiabetesGDMBMIAdolescentpregnancy |
| spellingShingle | Gabriel Chodick Maayan Omer-Gilon Estela Derazne Gal Puris Ran Rotem Dorit Tzur Orit Pinhas-Hamiel Tali Cukierman-Yaffe Avi Shina Inbar Zucker Amir Tirosh Arnon Afek Varda Shalev Gilad Twig Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes EClinicalMedicine gestational diabetes GDM BMI Adolescent pregnancy |
| title | Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes |
| title_full | Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes |
| title_fullStr | Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes |
| title_full_unstemmed | Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes |
| title_short | Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes |
| title_sort | adolescent body mass index and changes in pre pregnancy body mass index in relation to risk of gestational diabetes |
| topic | gestational diabetes GDM BMI Adolescent pregnancy |
| url | http://www.sciencedirect.com/science/article/pii/S2589537021004922 |
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