Body mass index and gestational weight gain in pregnant women with gestational diabetes and its relation with adverse maternal and fetal outcome

Authors

  • Abha Singh Department of Obstetrics and Gynecology, Pt. J. N. M. Medical College, Raipur, Chhattisgarh, India
  • Avinashi Kujur Department of Obstetrics and Gynecology, Pt. J. N. M. Medical College, Raipur, Chhattisgarh, India http://orcid.org/0000-0002-5585-5482
  • Archana Roy Department of Obstetrics and Gynecology, Pt. J. N. M. Medical College, Raipur, Chhattisgarh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20204323

Keywords:

Body mass index, Gestational diabetes mellitus, Gestational weight gain, Maternal and fetal outcome, Raised BMI, Pregnancy

Abstract

Background: Raised body mass index (BMI) and excessive gestational weight gain (GWG) are important determinants in development of gestational diabetes.

Methods: A prospective, observational study carried out on antenatal women since their first trimester. These women were screened for gestational diabetes mellitus (GDM) by diabetes in pregnancy study group of India (DIPSI) criteria. All participants were followed up by measuring their BMI, weight gain, blood sugars in every trimester. Also, data was collected regarding any adverse outcomes.

Results: Among all participants, 16.8% were diagnosed as GDM. 44% women of study group had weight gain beyond Institute of Medicine (IOM) recommendations. Higher risk of GDM was observed in women with raised BMI and excessive GWG. Also, odds of preeclampsia, preterm deliveries, caesarean section, macrosomia, intrauterine fetal death, neonatal intensive care unit (NICU) admissions were higher in women with GDM.

Conclusions: Compliance of recommended weight gain during pregnancy have a strong impact on the fetal outcome. Amount and timing of weight gain plays a crucial role in GDM.

Metrics

Metrics Loading ...

Author Biographies

Abha Singh, Department of Obstetrics and Gynecology, Pt. J. N. M. Medical College, Raipur, Chhattisgarh, India

DEPARTMENT OF OBSTETRICS AND GYNECOLOGY

DEAN,DIRECTOR PROFESSOR

Avinashi Kujur, Department of Obstetrics and Gynecology, Pt. J. N. M. Medical College, Raipur, Chhattisgarh, India

DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY,

ASSOCIATE PROFESSOR

Archana Roy, Department of Obstetrics and Gynecology, Pt. J. N. M. Medical College, Raipur, Chhattisgarh, India

DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY,

SENIOR RESIDENT

References

Kappil M, Wright RO, Sanders AP. Developmental origins of common disease: epigenetic contributions to obesity. Annu Rev Genomics Hum Genet. 2016;17(1):177-92.

Arora P, Aeri BT. Gestational Weight Gain among Healthy Pregnant Women from Asia in Comparison with Institute of Medicine (IOM) Guidelines-2009: A Systematic Review. J Pregnancy. 2019;3849596.

Rasmussen KM, Yaktine AL. Weight gain during pregnancy: re-examining the guidelines. Institute of Medicine and National Research Council of the National Academies. The National Academies Press, Washington. 2009.

Seshiah V, Das AK, Balaji V, Joshi SR, Parikh MN, Gupta S, et al. For Diabetes in Pregnancy Study Group. DIPSI Guidelines.

Ministry of health and family welfare, Govt of India. Maternal Health Division. Diagnosis and management of Gestational Diabetes technical guidelines. 2018.

Shridevi AS, Prabhudev P, Madusoodana RB. A clinical study of prevalence of gestational diabetes mellitus and associated risk factors at a tertiary care centre in Karnataka, India. Int J Reprod Contracept Obstet Gynecol. 2017;4(6):1840-5.

Mithal A, Bansal B, Kalra S. Gestational Diabetes in India: Science and society. Indian J Endocrinol Metab. 2015;19(6):701-4.

Bhatt AA, Dhore PB, Purandare VB, Sayyad MG, Mandal MK, Unnikrishnan AG. Gestational diabetes mellitus in rural population of Western India-Results of a community survey. Indian J Endocrinol Metab. 2015;19(4):507-10.

Martin KE, Grivell RM, Yelland LN, Dodd JM. The influence of maternal BMI and Gestational diabetes on pregnancy outcome. Diabetes Res Clin Pract. 2015;108(3):508-13.

Larrabure-Torrealva, G.T., Martinez, S., Luque-Fernandez, M.A., Sanchez S.E, Mascaro P.A., Ingar H et al. Prevalence and risk factors of gestational diabetes mellitus: findings from a universal screening feasibility program in Lima, Peru. BMC Pregnancy Childbirth 18, 303.

Hashim M, Radwan H, Hasan H, Obaid R S, Ghazal Al H, Hilali Al M et al. Gestational weight gain and gestational diabetes among Emirati and Arab women in the United Arab Emirates: results from MISC cohort. BMC Pregnancy and childbirth 2019; 19:463.

Kampmann U, Madsen LR, Skajaa GO, Iversen DS, Moeller N, Ovesen P. Gestational diabetes: a clinical update. World J Diabetes. 2015;6(8):1065.

Najafi F, Hasani J, Izadi N, Hashemi-Nazari SS, Zahra Namvar, Mohammadi S, et al. The effect of pre-pregnancy body mass index on the risk of gestational diabetes mellitus: A systematic review and dose-response meta-analysis. Obesity reviews. 2018;20(3):225-32.

Yao D, Chang Q, Wu QJ , Gao SY, Zhao H, Liu YS, et al. Relationship between maternal central obesity and the risk of gestational diabetes mellitus: A systematic review and meta-analysis of cohort studies. J Diabetes Res. 2020;6303820.

Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, et al. Association of gestational weight gain with maternal and infant outcomes: A systematic review and meta-analysis. JAMA. 2017;317(21):2207-25.

Viecceli C, Remonti LR, Hirakata VN, Mastella LS, Gnielka V, Oppermann MLR, et al. Weight gain adequacy and pregnancy outcomes in gestational diabetes: a meta-analysis. Obes Rev. 2017;18(5):567-80.

Johnson JL, Farr SL, Dietz PM, Sharma AJ, Wanda D, Barfield A, et al. Trends in gestational weight gain: the pregnancy risk assessment monitoring system, 2000-2009. Am J Obstet Gynecol. 2015;212:806:1-8.

Banagala BGCSM, Karunarathne M. The relationship of gestational weight gain and development of gestational diabetes mellitus. Sri Lanka J Obstet Gynecol. 2019;41:104-10.

MacDonald SC, Bodnar LM, Himes KP, Hutcheon JA. Patterns of gestational weight gain in early pregnancy and risk of gestational diabetes. Epidemiol. 2017;28(3):419-27.

Dimitriadou D, Mintziori G, Neofytidou O, Mousiolis A, Kotsa K, Kazakos K, et al. Compliance with gestational weight gain in women with gestational diabetes mellitus. Endocrine Abstracts. 2019;63:600.

Zhong C, Li X, Chen R, Zhou X, Liu C, Wu J, et al. Greater early and mid-pregnancy gestational weight gain are associated with increased risk of gestational diabetes mellitus: A prospective study. Clin Nutr ESPEN. 2017;22:48-53.

Boriboonhirusarn D. Second trimester weight gain more than 7 kg increases the risk of gestational diabetes after normal first trimester screening. J Obstet Gynecol Res. 2016;43(3):462-7.

Rong Ke, Yu K, Han X, Szeto IMY, Qin X, Wang J, et al. Pre-pregnancy BMI, gestational weight gain and post-partum weight retention: a meta-analysis of observational studies. Public Health Nutr. 2015;18(12):2172-82.

Whiting DR, Guariguata L, Weil C, Shaw J. IDF Diabetes Atlas: Global estimates of the prevalence of diabetes for 2011 and 2030, Diabetes Research and Clinical Practice. 2011;94(6):311-21.

Nair VG, Sandhu GS, Biswas M, Bhalla R. Evaluation of the incidence and outcome of gestational diabetes mellitus using the current international guidelines for diagnosing hyperglycemia in pregnancy. Int I Reprod Contracept Obstet Gynecol. 2016;5(10):3361-6.

Rajput M, Bairwa M, Rajput R. Prevalence of gestational diabetes mellitus in rural Haryana: A community-based study. Indian J Endocrinol Metab. 2014;18(3):350-4.

Mrema D, Lie RT, Ostbye T, Mahande MJ, Daltveit AK. The association between pre pregnancy body mass index and risk of preeclampsia: a registry-based study from Tanzania. BMC Pregnancy Childbirth. 2018;18:56.

Rahman MM, Abe SK, Kanda M, Narita S, Rahman MS, Bilano V, et al. Maternal body mass index and risk of birth and maternal health outcomes in low-and middle- income countries: a systematic review and meta-analysis. Obes Rev. 2015;16(9):758-70.

Castillejos AB, Gomez-Salgado J, Rodriguez-Almagro J, Ortiz-Esquinas I, Hernandez-Martinez A, et al. Relationship between maternal body mass index and obstetric and perinatal complications. J Clin Med. 2020;9(3):707.

Melchor I, Burgos J, Aiartzaguena A, Gutierrez J, Melchor JC. Effect of maternal obesity on pregnancy outcomes in women delivering singleton babies: a historical cohort study. J Perinat Med. 2019;47(6):625-30.

Shah PM, Chatrapati AK, Bandekar PK. Retrospective study on the effect of Body Mass Index (BMI) on maternal and neonatal outcome. Int J Reprod Contracept Obstet Gynecol. 2018;7(3):1070-3.

Doi L, Williams AJ, Marryat L, Frank J. Cohort study of high maternal body mass index and the risk of adverse pregnancy and delivery outcomes in Scotland. BMJ Open. 2020;10(2):026168.

Bhavadharini B, Anjana RM, Deepa M, Jayashree G, Nurtya S, Shobana M, et al. Gestational weight gain and pregnancy outcomes in relation to body mass index in Asian Indian Women. Indian J Endocr Metab. 2017;21:588-93.

Gavhane S, Sangle A, Gaikwad R. Relation of Birth weight with maternal pre-pregnancy weight and weight gain during pregnancy. 2018;6(3):9-12.

Su XJ, Huang SJ, Du QL. Pre pregnancy overweight and obesity are associated with an increased risk of preterm birth in Chinese women. Obes Facts. 2020;13(2):237-44.

Downloads

Published

2020-09-25

Issue

Section

Original Research Articles