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. 2020 Oct 18;9(10):3343.
doi: 10.3390/jcm9103343.

Inadequate Weight Gain According to the Institute of Medicine 2009 Guidelines in Women with Gestational Diabetes: Frequency, Clinical Predictors, and the Association with Pregnancy Outcomes

Xinglei Xie  1 , Jiaming Liu  1 , Isabel Pujol  2 , Alicia López  2 , María José Martínez  2 , Apolonia García-Patterson  3 , Juan M Adelantado  4 , Gemma Ginovart  5 , Rosa Corcoy  1   2   3   6
Affiliations

Inadequate Weight Gain According to the Institute of Medicine 2009 Guidelines in Women with Gestational Diabetes: Frequency, Clinical Predictors, and the Association with Pregnancy Outcomes

Xinglei Xie et al. J Clin Med. .

Abstract

Background: In the care of women with gestational diabetes mellitus (GDM), more attention is put on glycemic control than in factors such as gestational weight gain (GWG). We aimed to evaluate the rate of inadequate GWG in women with GDM, its clinical predictors and the association with pregnancy outcomes.

Methods: Cohort retrospective analysis.

Outcome variables: GWG according to Institute of Medicine 2009 and 18 pregnancy outcomes. Clinical characteristics were considered both as GWG predictors and as covariates in outcome prediction.

Statistics: descriptive, multinomial and logistic regression.

Results: We assessed 2842 women diagnosed with GDM in the 1985-2011 period. GWG was insufficient (iGWG) in 50.3%, adequate in 31.6% and excessive (eGWG) in 18.1%; length of follow-up for GDM was positively associated with iGWG. Overall pregnancy outcomes were satisfactory. GWG was associated with pregnancy-induced hypertension, preeclampsia, cesarean delivery and birthweight-related outcomes. Essentially, the direction of the association was towards a higher risk with eGWG and lower risk with iGWG (i.e., with Cesarean delivery and excessive growth).

Conclusions: In this cohort of women with GDM, inadequate GWG was very common at the expense of iGWG. The associations with pregnancy outcomes were mainly towards a higher risk with eGWG and lower risk with iGWG.

Keywords: Institute of Medicine; gestational diabetes mellitus; length of follow-up; pregnancy outcome; weight gain.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Scatterplot of gestational weight gain (in kg) vs. length of follow-up (in weeks).
Figure 1
Figure 1
Flowchart of inclusion of patients in the study. GDM: Gestation Diabetes Mellitus. GWG: Gestational Weight Gain.
Figure 2
Figure 2
Distribution of gestational weight gain according to Institute of Medicine 2009.
See this image and copyright information in PMC

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