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- W2564942008 abstract "Excess gestational weight gain (GWG) is associated with adverse outcomes in women with gestational diabetes (GDM), but patterns of gain across gestation are poorly understood. We evaluated the impact of pre- and post-diagnosis GWG on pregnancy outcomes in women with GDM. Weight gain patterns were characterized among a retrospective cohort of 1230 women with GDM who delivered between 2009-2012. Groups were determined based on the presence of excessive GWG before and after GDM diagnosis. Bivariate (chi square, t-test) and multivariable logistic regression analyses were used to assess the association between GWG patterns and pregnancy outcomes. Only 258 women (21%) did not have excessive GWG (E-GWG), 493 (40%) had E-GWG pre-diagnosis but not after, 91 (7%) had E-GWG post-diagnosis but not before, and 388 (32%) had persistent E-GWG throughout gestation (Figure). Women with persistent E-GWG were younger and had higher rates of obesity (56.4%, p<0.001) compared to other groups. Rates of medication use were higher in women with persistent E-GWG (67.4%) and those with E-GWG limited to after diagnosis (69.2%) compared to the two other groups. Rates of macrosomia, hypertensive disorders of pregnancy (HDP), and neonatal morbidity were higher in women with persistent E-GWG and those with E-GWG limited to post- diagnosis (Table). Compared to women without E-GWG, persistent E-GWG was independently associated with macrosomia (aOR 2.50, p=0.04) after controlling for confounders including pre-pregnancy BMI, glucose control, and gestational age. In contrast, E-GWG limited to post-GDM diagnosis was not independently associated with adverse pregnancy outcomes. E-GWG after GDM diagnosis, regardless of earlier gain, was associated with an increased risk for HDP (aOR 1.51, 95% CI 1.01-1.06). The pattern of gestational weight gain in women with GDM may influence pregnancy outcomes, and excessive gain after GDM diagnosis appears to increase the risk for adverse outcomes. Women should be counselled about the significant contribution of post-diagnosis excessive weight gain.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
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- W2564942008 date "2017-01-01" @default.
- W2564942008 modified "2023-09-27" @default.
- W2564942008 title "547: Patterns of gestational weight gain and pregnancy outcomes among women with gestational diabetes" @default.
- W2564942008 doi "https://doi.org/10.1016/j.ajog.2016.11.282" @default.
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