Patterns of weight gain in pregnant women with and without gestational diabetes mellitus: an observational study

Abstract

Objective: To quantify late-pregnancy weight gain in women with and without gestational diabetes mellitus (GDM) and to determine factors associated with gestational weight gain.

Study design: A prospective clinical audit of 212 women (115 GDM and 97 non-GDM) who were weighed at each antenatal visit from 24-32 weeks gestation until delivery. Women received routine antenatal clinical care. For women with GDM, this included a 2-h lifestyle counselling session, capillary blood glucose testing and frequent clinical review.

Results: Women with GDM gained less weight than nondiabetic women (GDM: 1.18 kg (1.6%) [range, 3.8-7.1 kg]; non-GDM: 4.0 kg (4.8%) [range, 0.7-18.5 kg]; P < 0.0001). Weight gain was influenced by body mass index and country of birth. Women with GDM showed reduced weight gain at weeks 1-4 postrecruitment, relative to weeks 4-8 (0.04 kg/week vs 0.45 kg/week; P < 0.0001). Nondiabetic women gained weight at a constant rate. GDM status was the only independent predictor of postrecruitment weight gain.

Conclusions: Application of a model of care for GDM (lifestyle advice and regular clinical review, in addition to home glucose monitoring) may reduce weight gain in women with GDM. The potential for applying a modified version of this model to all women in pregnancy warrants further study.