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 Gestational diabetes is a form of glucose intolerance that develops
for the first time during pregnancy. The condition is more common
among women who are overweight or obese when they become pregnant or
who gain a lot of weight during pregnancy.
“It is important to prevent gestational diabetes as it is associated
with complications in mothers and babies during birth, and health
care costs in mothers with gestational diabetes are 25 percent
higher compared to non-diabetic mothers,” said lead study author
Linn Marie Sorbye, a midwife and public health researcher at the
University of Bergen in Norway.
For the current study, researchers examined data on 24,198 mothers
in Norway with a first and second pregnancy between 2006 and 2014.
Compared to women whose weight didn’t fluctuate much after the first
pregnancy, women whose body mass index (BMI) - a ratio of weight to
height – rose significantly were between twice and more than five
times as likely to develop gestational diabetes during their second
pregnancy, the study found.
Overall, there were 18 cases of gestational diabetes for every 1,000
second pregnancies, researchers report in PLOS Medicine.
The focus on promoting healthy weight in the reproductive population
needs to be expanded to include preconception throughout
reproduction, Sorbye said by email.
Women who are underweight at the start of pregnancy should gain 28
to 40 pounds, while women who are normal weight are advised to gain
25 to 35 pounds, according to the U.S. Institute of Medicine. For
overweight women, a 15- to 25-pound gain is recommended and obese
women should gain just 11 to 20 pounds.
For a nonpregnant adult who is 5 feet 9 inches tall, gaining just
ten pounds is more than enough to go up more than one BMI unit, the
threshold in the study for an increased risk of gestational
diabetes.
Slightly more than one third of the women in the study gained more
than one BMI unit of weight between the start of their first
pregnancy and the start of their second pregnancy. This included
women who didn’t lose all of the weight after the first baby arrived
as well as women who gained extra pounds between pregnancies.
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Women who gained up to two BMI units of weight between pregnancies
had a doubled risk of gestational diabetes compared to women who
gained no more than one BMI unit, the study found. Women who gained
four BMI units, meanwhile, had a five-fold increased risk of
gestational diabetes.
A BMI calculator is available for free online from the National
Institutes of Health, at http://bit.ly/2tXeEf4.
The study wasn’t a controlled experiment designed to prove how or if
a failure to lose baby weight or a gain of extra pounds between
pregnancies causes gestational diabetes.
“Further research is needed to tease out exactly how changes in
weight, particularly over short time interpregnancy intervals, have
adverse metabolic effects in future pregnancies,” Dr. Jacinda
Nicklas, a researcher at the University of Colorado School of
Medicine who wasn’t involved in the study said by email.
Shorter periods between pregnancies may not give women enough time
to lose weight and increase their risk of gestational diabetes the
second time around, said Dr. Sharleen O’Reilly a researcher at
University College Dublin in Ireland.
“Weight loss should be a mix of healthy eating and more physical
activity, and we know that both together are more effective in
helping women lose weight after pregnancy,” O’Reilly said by email.
SOURCE: http://bit.ly/2vllnDk PLOS Medicine, online August 1, 2017.
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