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. 2023 Jul 13;23(1):513.
doi: 10.1186/s12884-023-05832-x.

Weight progression and adherence to weight gain target in women with vs. without gestational diabetes: a retrospective cohort study

Hong Miao #  1 , Feng Liang #  1 , Zheng Zheng  2 , Huimin Chen  3 , Xiaojun Li  1 , Yi Guo  1 , Kuanrong Li  1 , Xihong Liu  3 , Huimin Xia  4   5
Affiliations

Weight progression and adherence to weight gain target in women with vs. without gestational diabetes: a retrospective cohort study

Hong Miao et al. BMC Pregnancy Childbirth. .

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.

Keywords: Gestational diabetes mellitus; Gestational weight gain targets; Overweight and obesity; Weight progression.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The flow chart of the study population. Abbreviations: GDM, gestational diabetes mellitus; NGT, normal glucose tolerance. Abbreviations: GDM, gestational diabetes mellitus; NGT, normal glucose tolerance
Fig. 2
Fig. 2
Weight progression and density distribution of measured gestational age among NGT and GDM populations throughout pregnancy. Abbreviations: GDM, gestational diabetes mellitus; NGT, normal glucose tolerance; OGTT, oral glucose tolerance test
Fig. 3
Fig. 3
Adherence to Chinese gestational weight gain recommendations among women with GDM and NGT, stratified by pre-pregnancy BMI. Abbreviations: GDM, gestational diabetes mellitus; NGT, normal glucose tolerance; GWG, gestational weight gain; WGR, weight gain rate
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