1100 Impact of gestational weight gain in women with chronic hypertension and pre-gestational diabetes

2021 ◽  
Vol 224 (2) ◽  
pp. S678
Author(s):  
Grace J. Johnson ◽  
Haleh Sangi-Haghpeykar ◽  
Kjersti M. Aagaard ◽  
Alison N. Goulding ◽  
Matthew A. Shanahan ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Weight Gain ◽  
Chronic Hypertension ◽  
Gestational Weight

Rationale, design, and challenges with implementing a clinical intervention to teach appropriate gestational weight gain (TAGG): Protocol of a Randomized controlled trial (Preprint)

2019 ◽  
Author(s):  
Awathif Mackeen ◽  
Danielle Downs ◽  
Vonda Hetherington ◽  
Shawnee Lutcher ◽  
Jacob Mowery ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Usual Care ◽  
Gestational Weight Gain ◽  
Perceived Stress ◽  
Controlled Trial ◽  
Household Food Security ◽  
Gestational Weight ◽  
Randomized Controlled

BACKGROUND Excessive gestational weight gain (GWG) has public health implications including preterm birth, preeclampsia, gestational diabetes, and cesarean delivery. In an effort to mitigate adverse consequences of excessive GWG, this study tests a health intervention that includes enhancements to improve knowledge and awareness of appropriate GWG, and patient-centered nutritional counseling to promote appropriate GWG. OBJECTIVE The primary objective of the study was to increase the proportion of women who are managing their GWG as recommended by the IOM.4,5 METHODS This randomized controlled trial was conducted at Geisinger in Pennsylvania where excessive GWG is common among women with pre-conception obesity. Eligible, consenting participants with pre-pregnancy body mass index >30.0 kg/m2 were randomized (1:1) to: 1) Usual Care: usual written educational materials and counseling by an obstetric care provider or 2) Enhanced Care: Usual Care plus a) a personalized letter from a physician detailing appropriate GWG, b) exposure to individualized GWG chart in the electronic health record via the patient portal, and c) a consult with a Registered Dietitian Nutritionist and follow-up via tele-health counseling (10-20 mins/1-2 weeks) for the duration of the pregnancy. RESULTS The primary outcome was the proportion of women that gain less than 20 pounds over the course of the pregnancy. Secondary outcomes include knowledge, expectations, and attitude about pregnancy weight gain; increased self-efficacy for ability to eat healthy and being physically active to manage weight; and eating behavior. Potential moderators that will be explored include sleep, perceived stress, perceived involvement in care, and household food security. Data collection has been completed as of November 2019. CONCLUSIONS As GWG care was initiated for mothers with pre-pregnancy BMI >30 kg/m2 within the first and second trimesters, the intervention may have the additional benefit of reducing other adverse pregnancy outcomes including the incidence of gestational diabetes due to healthier rates of GWG. In addition to assessing appropriate GWG, this project will assess eating habits, physical activity, GWG attitudes, sleep quality, and psychological measures, all of which are associated with GWG. Exploratory mediators including perceived stress and food insecurity will also be evaluated. CLINICALTRIAL ClinicalTrials.gov NCT02963428

scholarly journals Association between Gestational Weight Gain, Gestational Diabetes Risk, and Obstetric Outcomes: A Randomized Controlled Trial Post Hoc Analysis

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1568 ◽  
Author(s):  
David Simmons ◽  
Roland Devlieger ◽  
Andre van Assche ◽  
Sander Galjaard ◽  
Rosa Corcoy ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Weight Gain ◽  
First Trimester ◽  
Obstetric Outcomes ◽  
Lifestyle Interventions ◽  
Gestational Weight ◽  
Randomized Controlled ◽  
Post Hoc

Excess gestational weight gain (GWG) is associated with the development of gestational diabetes mellitus (GDM). Lifestyle trials have not achieved much GWG limitation, and have largely failed to prevent GDM. We compared the effect of substantial GWG limitation on maternal GDM risk. Pregnant women with a body mass index (BMI) ≥29 kg/m2 <20 weeks gestation without GDM (n = 436) were randomized, in a multicenter trial, to usual care (UC), healthy eating (HE), physical activity (PA), or HE and PA lifestyle interventions. GWG over the median was associated with higher homeostasis model assessment insulin resistance (HOMA-IR) and insulin secretion (Stumvoll phases 1 and 2), a higher fasting plasma glucose (FPG) at 24–28 weeks (4.66 ± 0.43 vs. 4.61 ± 0.40 mmol/L, p < 0.01), and a higher rate of caesarean section (38% vs. 27% p < 0.05). The GWG over the median at 35–37 weeks was associated with a higher rate of macrosomia (25% vs. 16%, p < 0.05). A post hoc comparison among women from the five sites with a GWG difference >3 kg showed no significance difference in glycaemia or insulin resistance between HE and PA, and UC. We conclude that preventing even substantial increases in GWG after the first trimester has little effect on maternal glycaemia. We recommend randomized controlled trials of effective lifestyle interventions, starting in or before the first trimester.

445: The relationship between gestational weight gain and gestational diabetes mellitus

2015 ◽  
Vol 212 (1) ◽  
pp. S229
Author(s):  
Amy O'Higgins ◽  
Lisa O'Higgins ◽  
Anne Fennessy ◽  
Thomas McCartan ◽  
Laura Mullaney ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Weight Gain ◽  
Gestational Weight ◽  
The Relationship

scholarly journals Cardiometabolic and mental health in women with early gestational diabetes mellitus: A prospective cohort study

2021 ◽  
Author(s):  
Dan Yedu Quansah ◽  
Justine Gross ◽  
Leah Gilbert ◽  
Amelie Pauchet ◽  
Antje Horsch ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Prospective Cohort ◽  
Gestational Weight ◽  
Pregnancy And Postpartum ◽  
History Of

Abstract Context Early diagnosis and treatment of gestational diabetes (GDM) may reduce adverse obstetric and neonatal outcomes, especially in high-risk women. However, there is a lack of data for other outcomes. Objective We compared cardiometabolic and mental health outcomes in women with early (eGDM) and classical (cGDM) GDM. Methods This prospective cohort included 1185 women with cGDM and 76 women with eGDM. eGDM had GDM-risk factors (BMI &gt;30kg/m 2, family history of diabetes, history of GDM, ethnicity), were tested at &lt;20 weeks gestational age and diagnosed using ADA prediabetes criteria. Women underwent lifestyle adaptations. Obstetric, neonatal, mental, cardiometabolic outcomes were assessed during pregnancy and postpartum. Results eGDM had lower gestational weight gain than cGDM (10.7±6.2 vs 12.6±6.4, p=0.03), but needed more medical treatment (66% vs 42%, p&lt;0.001). They had similar rates of adverse maternal and neonatal outcomes, except for increased large-for-gestational-age infants (25% vs 15%, p=0.02). Mental health during pregnancy and postpartum did not differ between groups. eGDM had more atherogenic postpartum lipid profile than cGDM (p≤0.001). In eGDM, the postpartum prevalence of metabolic syndrome (MetS) was 1.8-times, prediabetes was 3.1-times and diabetes was 7.4-times higher than cGDM (MetS-waist circumference-based: 62% vs 34%/MetS-BMI-based: 46% vs 24%; prediabetes: 47.5% vs 15.3%; diabetes: 11.9% vs 1.6%, all p&lt;0.001). These differences remained unchanged after adjusting for GDM-risk factors. Conclusion Compared to cGDM, eGDM was not associated with differences in mental health, but with increased adverse cardiometabolic outcomes, independent of GDM-risk factors and gestational weight gain. This hints to a pre-existing risk-profile in eGDM.

scholarly journals The impact of restricted gestational weight gain by dietary intervention on fetal growth in women with gestational diabetes mellitus

Diabetologia ◽  
2018 ◽  
Vol 61 (12) ◽  
pp. 2528-2538 ◽  
Author(s):  
Lise L. Kurtzhals ◽  
Sidse K. Nørgaard ◽  
Anna L. Secher ◽  
Vibeke L. Nichum ◽  
Helle Ronneby ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Weight Gain ◽  
Fetal Growth ◽  
Dietary Intervention ◽  
Gestational Weight ◽  
The Impact

Association of Maternal Serum Zinc, Copper and Magnesium Levels, Pre-pregnancy Body Mass Index and Gestational Weight Gain Patterns With the Risk of Gestational Diabetes Mellitus Among Third-trimester Pregnant Women: a Cross-sectional Study

2021 ◽  
Author(s):  
Masoomeh Gholizadeh ◽  
Tohid Rouzitalab ◽  
Saeid Ghavamzadeh ◽  
Elnaz Daneshzad
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Serum Zinc ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Gestational Weight

Abstract Background: This study sought to evaluate the association between selected micronutrients (zinc, copper, and magnesium), pre-pregnancy BMI, and weight gain during pregnancy with the risk of gestational diabetes mellitus third-trimester pregnant women Urmia, Iran. Methods: This analytic cross-sectional study included 400 pregnant women. The nutritional, demographic, clinical data, and fasting blood samples (selected micronutrients and blood glucose) were evaluated. The data were analyzed using chi-square, independent t-test, and logistic regression tests. Results: The prevalence of gestational diabetes mellitus (GDM) was 18%. The OR for GDM was (OR: 0.329; 95% CI: 0.156-0.696) in normal-weight compared to mothers who were obese before pregnancy. Normal serum zinc concentration was associated with 0.413-fold lower rates of developing GDM (95% CI: 0.227-0.750). Magnesium supplementation was inversely associated with the risk of GDM (OR: 0.986; 95% CI: 0.979-0.994). Inadequate and excessive gestational weight gain was significantly associated with developing GDM in lean and obese women before pregnancy, respectively (p=0.01, p=0.003). Conclusions: Gestational diabetes is highly prevalent in Urmia, and it is likely related to excessive serum zinc concentrations, elevated pre-pregnancy BMI, and gestational weight gain.

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