Weight progression and adherence to weight gain target in women with vs. without gestational diabetes: a retrospective cohort study
Abstract Background Weight management has been an important component of the service in obstetric care offered to pregnant women. Current gestational weight gain recommendations were primarily for the general obstetric population, raising concern about the applicability to women with gestational dia...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-023-05832-x |
| _version_ | 1797778648663588864 |
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| author | Hong Miao Feng Liang Zheng Zheng Huimin Chen Xiaojun Li Yi Guo Kuanrong Li Xihong Liu Huimin Xia |
| author_facet | Hong Miao Feng Liang Zheng Zheng Huimin Chen Xiaojun Li Yi Guo Kuanrong Li Xihong Liu Huimin Xia |
| author_sort | Hong Miao |
| collection | DOAJ |
| description | Abstract Background Weight management has been an important component of the service in obstetric care offered to pregnant women. Current gestational weight gain recommendations were primarily for the general obstetric population, raising concern about the applicability to women with gestational diabetes mellitus (GDM). We aimed to assess the difference in weight progression and adherence to the recommended gestational weight gain targets between women with gestational diabetes mellitus (GDM) and women with normal glucose tolerance (NGT). Methods This was a hospital-based retrospective study of 56,616 pregnant women (9,430 GDM women and 47,186 NGT women) from Guangzhou between 2017 and 2021. The average change in weight progression was estimated based on serial weight measurements throughout pregnancy, using a mixed effects model with a random intercept to account for repeated measures of the same individual. Results Women with GDM gained less weight (12.07 [SD 5.20] kg) than women with NGT (14.04 [SD 5.04] kg) throughout pregnancy. Before OGTT, a small difference was observed in the average change in weight progression between the two groups (GDM, 0.44 kg/week vs. NGT, 0.45 kg/week, p < 0.001), however, this gap widened significantly after the test (0.34 vs. 0.50 kg/week, p < 0.001). GDM individuals were identified with an approximately 4-fold increased proportion of insufficient weight gain (41.1% vs. 10.4%) and a 2-fold decreased proportion of excessive weight gain (22.6% vs. 54.2%) compared to NGT individuals. These results were consistently observed across different BMI categories, including underweight (insufficient: 52.7% vs. 19.9%; excessive: 15.6% vs. 35.3%), normal weight (insufficient 38.2% vs. 7.4%; excessive: 22.2% vs. 57.3%), and overweight/obese (insufficient: 43.1% vs. 9.8%; excessive: 30.1% vs. 68.8%). Conclusion Weight progression varied significantly between GDM and NGT individuals, resulting in a substantial difference in identifying insufficient and excessive weight gain between the two groups under current gestational weight gain guidelines. |
| first_indexed | 2024-03-12T23:20:28Z |
| format | Article |
| id | doaj.art-9a500dd8f06a4d4db651c8dcd6e15dc6 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-12T23:20:28Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-9a500dd8f06a4d4db651c8dcd6e15dc62023-07-16T11:31:04ZengBMCBMC Pregnancy and Childbirth1471-23932023-07-012311910.1186/s12884-023-05832-xWeight progression and adherence to weight gain target in women with vs. without gestational diabetes: a retrospective cohort studyHong Miao0Feng Liang1Zheng Zheng2Huimin Chen3Xiaojun Li4Yi Guo5Kuanrong Li6Xihong Liu7Huimin Xia8Clinical Data Center, Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityClinical Data Center, Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Obstetrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Clinical Nutrition, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityClinical Data Center, Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityClinical Data Center, Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityClinical Data Center, Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Clinical Nutrition, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityClinical Data Center, Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityAbstract Background Weight management has been an important component of the service in obstetric care offered to pregnant women. Current gestational weight gain recommendations were primarily for the general obstetric population, raising concern about the applicability to women with gestational diabetes mellitus (GDM). We aimed to assess the difference in weight progression and adherence to the recommended gestational weight gain targets between women with gestational diabetes mellitus (GDM) and women with normal glucose tolerance (NGT). Methods This was a hospital-based retrospective study of 56,616 pregnant women (9,430 GDM women and 47,186 NGT women) from Guangzhou between 2017 and 2021. The average change in weight progression was estimated based on serial weight measurements throughout pregnancy, using a mixed effects model with a random intercept to account for repeated measures of the same individual. Results Women with GDM gained less weight (12.07 [SD 5.20] kg) than women with NGT (14.04 [SD 5.04] kg) throughout pregnancy. Before OGTT, a small difference was observed in the average change in weight progression between the two groups (GDM, 0.44 kg/week vs. NGT, 0.45 kg/week, p < 0.001), however, this gap widened significantly after the test (0.34 vs. 0.50 kg/week, p < 0.001). GDM individuals were identified with an approximately 4-fold increased proportion of insufficient weight gain (41.1% vs. 10.4%) and a 2-fold decreased proportion of excessive weight gain (22.6% vs. 54.2%) compared to NGT individuals. These results were consistently observed across different BMI categories, including underweight (insufficient: 52.7% vs. 19.9%; excessive: 15.6% vs. 35.3%), normal weight (insufficient 38.2% vs. 7.4%; excessive: 22.2% vs. 57.3%), and overweight/obese (insufficient: 43.1% vs. 9.8%; excessive: 30.1% vs. 68.8%). Conclusion Weight progression varied significantly between GDM and NGT individuals, resulting in a substantial difference in identifying insufficient and excessive weight gain between the two groups under current gestational weight gain guidelines.https://doi.org/10.1186/s12884-023-05832-xGestational diabetes mellitusWeight progressionGestational weight gain targetsOverweight and obesity |
| spellingShingle | Hong Miao Feng Liang Zheng Zheng Huimin Chen Xiaojun Li Yi Guo Kuanrong Li Xihong Liu Huimin Xia Weight progression and adherence to weight gain target in women with vs. without gestational diabetes: a retrospective cohort study BMC Pregnancy and Childbirth Gestational diabetes mellitus Weight progression Gestational weight gain targets Overweight and obesity |
| title | Weight progression and adherence to weight gain target in women with vs. without gestational diabetes: a retrospective cohort study |
| title_full | Weight progression and adherence to weight gain target in women with vs. without gestational diabetes: a retrospective cohort study |
| title_fullStr | Weight progression and adherence to weight gain target in women with vs. without gestational diabetes: a retrospective cohort study |
| title_full_unstemmed | Weight progression and adherence to weight gain target in women with vs. without gestational diabetes: a retrospective cohort study |
| title_short | Weight progression and adherence to weight gain target in women with vs. without gestational diabetes: a retrospective cohort study |
| title_sort | weight progression and adherence to weight gain target in women with vs without gestational diabetes a retrospective cohort study |
| topic | Gestational diabetes mellitus Weight progression Gestational weight gain targets Overweight and obesity |
| url | https://doi.org/10.1186/s12884-023-05832-x |
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