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Evaluating gestational weight gain recommendations in pregestational diabetes
Anne M Siegel1, Alan Tita1, Joseph R Biggio1
1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham School of Medicine, Birmingham, AL.
American Journal of Obstetrics and Gynecology
|July 30, 2015
Summary
Gestational weight gain outside Institute of Medicine recommendations in women with pregestational diabetes is linked to higher risks of large for gestational age and macrosomic newborns. Counseling to achieve recommended gestational weight gain is crucial for better perinatal outcomes.
Area of Science:
- Reproductive Medicine
- Maternal-Fetal Medicine
- Endocrinology
Background:
- The Institute of Medicine (IOM) lacks specific gestational weight gain (GWG) guidelines for women with pregestational diabetes.
- Assessing GWG deviations from IOM recommendations is vital for understanding perinatal risks in this population.
Purpose of the Study:
- To evaluate the impact of gestational weight gain (GWG) outside of Institute of Medicine (IOM) recommendations on perinatal outcomes in women with pregestational diabetes.
Main Methods:
- Retrospective cohort study of 340 singletons with pregestational diabetes (2008-2013).
- Women categorized by GWG relative to IOM recommendations (within, less than, greater than).
- Analysis of maternal (cesarean delivery, preeclampsia, glycemic control) and neonatal (birthweight, SGA, LGA, macrosomia, preterm delivery, birth injury) outcomes, adjusted for confounders.
Main Results:
- 70.3% of women exceeded IOM GWG recommendations.
- No significant differences in cesarean delivery, preeclampsia, glycemic control, preterm delivery, or birth injury.
- Increased incidence of large for gestational age (LGA) and macrosomia correlated with higher GWG categories (AORs 3.08 and 4.02, respectively).
- Risk of LGA and macrosomia was not explained by glycemic control differences.
Conclusions:
- Women with pregestational diabetes should aim for GWG within IOM recommendations.
- Adhering to GWG guidelines can help prevent large for gestational age (LGA) and macrosomic newborns.
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