Second Trimester Insulin Resistance, Early Pregnancy Body Mass Index and Gestational Weight Gain

The objective of the study is to analyze the association between early pregnancy body mass index (BMI), gestational weight gain (GWG), and maternal and neonatal outcomes. The retrospective cohort study was conducted at Quanzhou First Hospital Affiliated to Fujian Medical University from January 2018 to May 2021, with 552 women enrolled. Women were divided into the underweight group, normal weight group, overweight group, and obese group according to early pregnancy BMI. Univariate and multivariate logistic regression analyses were performed. The absolute risk of adverse maternal and neonatal outcomes in the early pregnancy BMI group was calculated to further analyze the association between GWG and adverse maternal and neonatal outcomes. Of the 552 women, 390 (70.65%) women had adverse maternal and neonatal outcomes. The result revealed that overweight was associated with increased risk of adverse maternal and neonatal outcomes (odds ratio (OR): 1.643, 95% confidence interval (CI): 1.006-2.684), maternal complications (OR: 1.937, 95% CI: 1.188-3.159), and large for gestational age (LGA) (OR: 1.905, 95% CI: 1.061-3.422). In the obese group, the risk of adverse maternal and neonatal outcomes (OR: 5.760, 95% CI: 1.997-16.786), maternal complications (OR: 3.112, 95% CI: 1.645-5.887), gestational diabetes mellitus (GDM) (OR: 2.943, 95% CI: 1.509-5.741), cesarean section (OR: 1.899, 95% CI: 1.002-3.599), and preterm delivery (OR: 4.752, 95% CI: 1.395-16.185) increased. Besides, there was an association between insufficient GWG and decreased risk of LGA (OR: 0.392, 95% CI: 0.187-0.826) and higher risk of preterm delivery (OR: 2.818, 95% CI: 1.171-6.784). This study demonstrates that BMI and GWG are related to maternal and neonatal outcomes. It is necessary to regularly monitor the weight of pregnant women during pregnancy. And regional guidelines for GWG also need to be explored.

Download Full-text

Abstract #534 Influence of Gestational Weight Gain and Pre-Pregnancy Body Mass Index on Birth Weight

Endocrine Practice ◽

10.1016/s1530-891x(20)46878-8 ◽

2019 ◽

Vol 25 ◽

pp. 268-269

Author(s):

Bolanle Okunowo ◽

Ifedayo Odeniyi ◽

Oluwarotimi Olopade ◽

Olufemi Fasanmade ◽

Omololu Adegbola ◽

...

Keyword(s):

Body Mass Index ◽

Weight Gain ◽

Birth Weight ◽

Gestational Weight Gain ◽

Body Mass ◽

Gestational Weight

Download Full-text

The effects of pre-pregnancy obesity and gestational weight gain on maternal lipid profiles, fatty acids and insulin resistance

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0540 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Muge Gul Gulecoglu Onem ◽

Canan Coker ◽

Kemal Baysal ◽

Sabahattin Altunyurt ◽

Pembe Keskinoglu

Keyword(s):

Insulin Resistance ◽

Fatty Acids ◽

Lipid Metabolism ◽

Weight Gain ◽

Pregnant Women ◽

Total Cholesterol ◽

Gestational Weight Gain ◽

Hdl Cholesterol ◽

Second Trimester ◽

Gestational Weight

Abstract Objectives Pregnancy is associated with physiological alterations in insulin sensitivity and lipid metabolism. This study investigates the associations between pregestational body mass index (pBMI) and the rate of gestational weight gain (rGWG) in the second trimester with the biomarkers of lipid, fatty acids metabolism and insulin resistance. Methods Sixty nine pregnant women followed. The body weights of the pregnant women were measured and blood samples were obtained at 11–14th and 24–28th weeks of pregnancy. Glucose, total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol, insulin levels and fatty acids were measured. Rate of GWG (kg/week) and The Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) were calculated. The pregnant women were stratified according to their pBMI and the 2nd trimester rGWG. Results The rate of GWG was significantly higher for the group with pBMI<25, compared to the group with pBMI≥25 (p=0.024). Triglyceride, total cholesterol, LDL and HDL cholesterol were significantly increased in the second trimester compared with the first trimester. Palmitic acid, oleic acid, linoleic acid, myristic acid, docosahexaenoic acid (DHA), arachidonic acid (AA), total omega-6 (n − 6) and omega-3 (n − 3) fatty acid levels and n − 6/n − 3 ratio were significantly higher in the second trimester. Glucose was significantly decreased and insulin was increased in the second trimester. In the overweight/obese group; HOMA-IR, insulin, AA, palmitoleic acid and stearic acid were found to be high in comparison to the group with low/normal pBMI. No parameters were associated with rGWG. Conclusions The changes in lipid parameters, free fatty acids, insulin and HOMA-IR in the second trimester were compatible with the changes in lipid metabolism and the development of insulin resistance. Pregestational BMI was shown to have a stronger influence on lipid profile, insulin resistance, and fatty acids than rGWG.

Download Full-text