(Ivanhoe Newswire) -- Women who gain excessive weight during pregnancy,
especially in the first trimester, may increase their risk of developing
diabetes later in pregnancy.
A three-year study by the Kaiser Permanente Division of Research of 1,145
pregnant women from an ethnically diverse population found that women who gained
more weight than is recommended by the Institute of Medicine had a 50 percent
increased risk of developing gestational diabetes mellitus (GDM). The
association between pregnancy weight gain and gestational diabetes was more
pronounced among overweight and non-white women. The study included 345 pregnant
women with gestational diabetes and 800 pregnant women without gestational
diabetes.
Gestational diabetes is defined as glucose intolerance that typically occurs
during the second or third trimester of pregnancy. It causes complications in as
many as seven percent of pregnancies in the United States. It can lead to early
delivery, C-sections and type 2 diabetes, and can increase the child's risk of
developing diabetes and obesity later in life.
The study followed women members of Kaiser Permanente Northern California region
and examined their overall rate of pregnancy weight gain up to the time of
screening for gestational diabetes (typically between 24-28 weeks), as well as
the trimester-specific rates of weight gain compared to the Institute of
Medicine's 2009 guidelines for recommended pregnancy weight gain.
After adjusting for age at delivery, race/ethnicity, previous births, and
pre-pregnancy body mass index, the risk of gestational diabetes increased with
increasing rates of pregnancy weight gain. Women who exceeded the IOM guidelines
for weight gain had a 50 percent increase in the risk of gestational diabetes
compared to women who gained within or below the IOM recommendations.
The researchers hypothesized that rapid weight gain early in pregnancy may
result in an early increase in insulin resistance that leads to the "exhaustion"
of the beta-cells in the pancreas that make and release insulin, which controls
the level of glucose in the blood. This could reduce beta-cells' capacity to
secrete adequate levels of insulin to compensate for the insulin resistance
induced by the progression of pregnancy and therefore lead to the development of
gestational diabetes.
Lead author Monique Hedderson, Ph.D., at the Kaiser Permanente Division of
Research, was quoted as saying, "Health care providers should talk to their
patients early in their pregnancy about the appropriate gestational weight gain,
especially during the first trimester, and help women monitor their weight gain.
Our research shows that weight gain in early pregnancy is a modifiable risk
factor for gestational diabetes. Randomized studies are needed to determine the
feasibility of this early intervention and the best methods to help women meet
the IOM recommendations."
SOURCE: Obstetrics and Gynecology, February 22, 2010
