Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Feb;32(3):239-46.
doi: 10.1055/s-0034-1383846. Epub 2014 Jun 27.

The institute of medicine guidelines for gestational weight gain after a diagnosis of gestational diabetes and pregnancy outcomes

Lorie M Harper  1 , Alan Tita  1 , Joseph R Biggio  1
Affiliations

The institute of medicine guidelines for gestational weight gain after a diagnosis of gestational diabetes and pregnancy outcomes

Lorie M Harper et al. Am J Perinatol. 2015 Feb.

Abstract

Objective: The objective of this study was to assess the impact of gestational weight gain outside the Institute of Medicine (IOM) recommendations after the diagnosis of gestational diabetes (GDM) on perinatal outcomes.

Materials and methods: This was a retrospective cohort study. Women were classified as gestational weight gain (GWG) within, less than, or greater than IOM recommendations for body mass index as calculated by gestational weight gain per week after a diagnosis of GDM. Outcomes assessed were preeclampsia, cesarean delivery, A2 GDM, birth weight, small for gestational age (SGA), large for gestational age (LGA), macrosomia, and preterm delivery. Groups were compared using analysis of variance and chi-square test for trend, as appropriate. Backward stepwise logistic regression was used to adjust for significant confounding factors.

Results: Of 635 subjects, 92 gained within, 175 gained less than, and 368 gained more than IOM recommendations. The risk of cesarean delivery and A2 GDM was increased in those gaining above the IOM recommendations compared with within. For every 1-lb/week increase in weight gain after diagnosis of GDM, there was a 36 to 83% increase in the risk of preeclampsia, cesarean delivery, A2 GDM, macrosomia, and LGA, without decreases in SGA or preterm delivery.

Conclusion: Weight gain more than the IOM recommendations per week of gestation after a diagnosis of GDM is associated with adverse pregnancy outcomes.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflict of interest.

Figures

Figure 1
Figure 1
Adjusted odds ratio and 95% confidence interval for maternal and neonatal outcomes per kilogram of weight gain after a diagnosis of gestational diabetes. Adjusted for weight gain until the diagnosis of GDM, pre-pregnancy body mass index, and maternal age.
See this image and copyright information in PMC

References

    1. Institute of Medicine. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press; 2009. - PubMed
    1. Viswanathan M, Siega-Riz AM, Moos MK, et al. Outcomes of maternal weight gain. Evidence report/technology assessment. 2008;(168):1–223. - PMC - PubMed
    1. American College of O, Gynecologists Women's Health Care P. Practice Bulletin No. 137: Gestational diabetes mellitus. Obstetrics and gynecology. 2013;122(2 Pt 1):406–416. - PubMed
    1. Carreno CA, Clifton RG, Hauth JC, et al. Excessive early gestational weight gain and risk of gestational diabetes mellitus in nulliparous women. Obstetrics and gynecology. 2012;119(6):1227–1233. - PMC - PubMed
    1. Hedderson MM, Gunderson EP, Ferrara A. Gestational weight gain and risk of gestational diabetes mellitus. Obstetrics and gynecology. 2010;115(3):597–604. - PMC - PubMed

Publication types