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Metabolic syndrome of weight change from pre-pregnancy to 1-5 years post-partum among Chinese women with prior gestational diabetes.

ABSTRACT: Few studies have evaluated the effect of weight change from pre-pregnancy to post-partum with the risk of cardiometabolic diseases among women with a history of gestational diabetes mellitus. The aim of this study was to evaluate the association between weight change from pre-pregnancy to 1-5 years post-partum with metabolic syndrome among Chinese women with prior gestational diabetes mellitus.We performed a retrospective cohort study in 1263 women with gestational diabetes mellitus at 1-5 years post-partum. Participants were divided into four groups based on their weight change from pre-pregnancy to 1-5 years post-partum: loss of ? 3 kg, ± 3 kg, gain of 3-7 kg and gain of ?7 kg.The prevalence of metabolic syndrome was 12.1%, 16.2%, 26.0% and 44.3% among women with weight loss ? 3 kg, stable weight ( ± 3 kg), weight gain 3-7 kg and weight gain ? 7 kg from pre-pregnancy to post-partum, respectively. The positive association between weight change and metabolic syndrome was observed among women with pre-pregnancy normal weight (BMI < 24 kg/m(2)), overweight (BMI 24-27.9 kg/m(2)) and obesity (BMI ? 28 kg/m(2)). The prevalence of metabolic syndrome was almost similar among pre-pregnancy normal weight women with weight gain ? 7 kg, pre-pregnancy overweight women with stable weight ( ± 3 kg) and pre-pregnancy obese women with weight loss ? 3 kg from pre-pregnancy to post-partum (P = 0.62).Women with gestational diabetes mellitus who had large weight gain from pre-pregnancy to post-partum were more likely to develop metabolic syndrome. Women who are pre-pregnancy overweight/obesity and also diagnosed as gestational diabetes mellitus during pregnancy need more weight control after delivery.

SUBMITTER: Li W

PROVIDER: S-EPMC4615340 | biostudies-literature | 2015 Nov

REPOSITORIES: biostudies-literature

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Metabolic syndrome of weight change from pre-pregnancy to 1-5 years post-partum among Chinese women with prior gestational diabetes.

Li W W Liu H H Qiao Y Y Lv F F Zhang S S Wang L L Leng J J Liu H H Qi L L Tuomilehto J J Hu G G

Diabetic medicine : a journal of the British Diabetic Association 20150528 11

<h4>Aims</h4>Few studies have evaluated the effect of weight change from pre-pregnancy to post-partum with the risk of cardiometabolic diseases among women with a history of gestational diabetes mellitus. The aim of this study was to evaluate the association between weight change from pre-pregnancy to 1-5 years post-partum with metabolic syndrome among Chinese women with prior gestational diabetes mellitus.<h4>Methods</h4>We performed a retrospective cohort study in 1263 women with gestational d ...[more]

PMID: 25962467

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Project description:Excessive pre-pregnancy weight is a known risk factor of pregnancy complications. The purpose of this analysis was to assess the relationship between several categories of maternal weight and the risk of developing hypertension and diabetes in pregnancy, and the relationship of these complications with the results of the newborn. It was carried out in a common cohort of pregnant women and taking into account the influence of disturbing factors. Our analysis was conducted in a prospective cohort of 912 Polish pregnant women, recruited during 2015-2016. We evaluated the women who subsequently developed diabetes with dietary modification (GDM-1) (n = 125) and with insulin therapy (GDM-2) (n = 21), as well as the women who developed gestational hypertension (GH) (n = 113) and preeclampsia (PE) (n = 24), compared to the healthy controls. Odds ratios of the complications (and confidence intervals (95%)) were calculated in the multivariate logistic regression. In the cohort, 10.8% of the women had pre-pregnancy obesity (body mass index (BMI) ? 30 kg/m2), and 36.8% had gestational weight gain (GWG) above the range of the Institute of Medicine recommendation. After correction for excessive GWG and other confounders, pre-pregnancy obesity (vs. normal BMI) was associated with a higher odds ratio of GH (AOR = 4.94; p < 0.001), PE (AOR = 8.61; p < 0.001), GDM-1 (AOR = 2.99; p < 0.001), and GDM-2 (AOR = 11.88; p <0.001). The threshold risk of development of GDM-2 occurred at lower BMI values (26.9 kg/m2), compared to GDM-1 (29.1 kg/m2). The threshold point for GH was 24.3 kg/m2, and for PE 23.1 kg/m2. For GWG above the range (vs. GWG in the range), the adjusted odds ratios of GH, PE, GDM-1, and GDM-2 were AOR = 1.71 (p = 0.045), AOR = 1.14 (p = 0.803), AOR = 0.74 (p = 0.245), and AOR = 0.76 (p = 0.672), respectively. The effect of maternal edema on all the results was negligible. In our cohort, hypertension and diabetes were associated with incorrect birth weight and gestational age at delivery. Conclusions: This study highlights the importance and influence of excessive pre-pregnancy maternal weight on the risk of pregnancy complications such as diabetes and hypertension which can impact fetal outcomes.

Project description:OBJECTIVE:To explore the joint and independent effects of gestational weight gain (GWG) and pre-pregnancy body mass index (BMI) on pregnancy outcomes in a population of Chinese Han women and to evaluate pregnant women's adherence to the 2009 Institute of Medicine (IOM) gestational weight gain guidelines. METHODS:This was a multicenter, retrospective cohort study of 48,867 primiparous women from mainland China who had a full-term singleton birth between January 1, 2011 and December 30, 2011. The independent associations of pre-pregnancy BMI, GWG and categories of combined pre-pregnancy BMI and GWG with outcomes of interest were examined using an adjusted multivariate regression model. In addition, women with pre-pregnancy hypertension were excluded from the analysis of the relationship between GWG and delivery of small-for-gestational-age (SGA) infants, and women with gestational diabetes (GDM) were excluded from the analysis of the relationship between GWG and delivery of large-for-gestational-age (LGA) infants. RESULTS:Only 36.8% of the women had a weight gain that was within the recommended range; 25% and 38.2% had weight gains that were below and above the recommended range, respectively. The contribution of GWG to the risk of adverse maternal and fetal outcomes was modest. Women with excessive GWG had an increased likelihood of gestational hypertension (adjusted OR 2.55; 95% CI = 1.92-2.80), postpartum hemorrhage (adjusted OR 1.30; 95% CI = 1.17-1.45), cesarean section (adjusted OR 1.31; 95% CI = 1.18-1.36) and delivery of an LGA infant (adjusted OR 2.1; 95% CI = 1.76-2.26) compared with women with normal weight gain. Conversely, the incidence of GDM (adjusted OR 1.64; 95% CI = 1.20-1.85) and SGA infants (adjusted OR 1.51; 95% CI = 1.32-1.72) was increased in the group of women with inadequate GWG. Moreover, in the obese women, excessive GWG was associated with an apparent increased risk of delivering an LGA infant. In the women who were underweight, poor weight gain was associated with an increased likelihood of delivering an SGA infant. After excluding the mothers with GDM or gestational hypertension, the ORs for delivery of LGA and SGA infants decreased for women with high GWG and increased for women with low GWG. CONCLUSIONS:GWG above the recommended range is common in this population and is associated with multiple unfavorable outcomes independent of pre-pregnancy BMI. Obese women may benefit from avoiding weight gain above the range recommended by the 2009 IOM. Underweight women should avoid low GWG to prevent delivering an SGA infant. Pregnant women should therefore be monitored to comply with the IOM recommendations and should have a balanced weight gain that is within a range based on their pre-pregnancy BMI.

Dataset Information

Metabolic syndrome of weight change from pre-pregnancy to 1-5 years post-partum among Chinese women with prior gestational diabetes.

Publications

Metabolic syndrome of weight change from pre-pregnancy to 1-5 years post-partum among Chinese women with prior gestational diabetes.

Similar Datasets

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