The Effect of Gestational Weight Gain on Neonatal Birth Weight in Obese Women With Type 2 Diabetes [38P]

AbstractBackgroundClinical recommendations to limit gestational weight gain (GWG) imply high GWG is causally related to adverse outcomes in mother or offspring, but GWG is the sum of several inter-related complex phenotypes (maternal fat deposition and vascular expansion, placenta, amniotic fluid and fetal growth). Understanding the genetic contribution to GWG could help clarify the potential effect of its different components on maternal and offspring health. Here we explore the genetic contribution to total, early and late GWG.Participants and MethodsA genome-wide association study was used to identify maternal and fetal variants contributing to GWG in up to 10,543 mothers and up to 16,317 offspring of European origin, with replication in 10,660 mothers and 7,561 offspring. Additional analyses determined the proportion of variability in GWG from maternal and fetal common genetic variants and the overlap of established genome-wide significant variants for phenotypes relevant to GWG (e.g. maternal BMI and glucose, birthweight).ResultsWe found that approximately 20% of the variability in GWG was tagged by common maternal genetic variants, and that the fetal genome made a surprisingly minor contribution to explaining variation in GWG. We were unable to identify any genetic variants that reached genome-wide levels of significance (P<5×10−8) and replicated. Some established maternal variants associated with increased BMI, fasting glucose and type 2 diabetes were associated with lower early, and higher later GWG. Maternal variants related to higher systolic blood pressure were related to lower late GWG. Established maternal and fetal birthweight variants were largely unrelated to GWG.ConclusionWe found a modest contribution of maternal common variants to GWG and some overlap of maternal BMI, glucose and type 2 diabetes variants with GWG. These findings suggest that associations between GWG and later offspring/maternal outcomes may be due to the relationship of maternal BMI and diabetes with GWG.

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Effect of motivational interviewing on gestational weight gain and fetal growth in pregnant women with type 2 diabetes

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-000733 ◽

2019 ◽

Vol 7 (1) ◽

pp. e000733

Author(s):

Björg Ásbjörnsdóttir ◽

Marianne Vestgaard ◽

Lene Ringholm ◽

Lise Lotte Torvin Andersen ◽

Dorte Møller Jensen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Weight Gain ◽

Motivational Interviewing ◽

Pregnant Women ◽

Gestational Weight Gain ◽

Healthy Eating ◽

Routine Care ◽

Gestational Weight ◽

Reference Cohort

ObjectiveTo study how lifestyle coaching with motivational interviewing to improve adherence to healthy eating affects gestational weight gain and fetal growth in pregnant women with type 2 diabetes in a real-world setting.Research design and methodsA cohort study including a prospective intervention cohort of consecutive, singleton pregnant, Danish-speaking women with type 2 diabetes included between August 2015 and February 2018 and a historical reference cohort included between February 2013 and August 2015. The intervention consisted of a motivational interviewing to improve adherence to healthy eating in addition to routine care. The reference cohort received routine care only. The main outcomes were gestational weight gain and large for gestational age (LGA) infants.ResultsNinety-seven women were included in the intervention cohort and 92 in the reference cohort. Pre-pregnancy body mass index (32.8±6.9 kg/m2vs 32.4±7.4 kg/m2, p=0.70), gestational weight gain (9.2±5.8 kg vs 10.2±5.8 kg, p=0.25), HbA1c in early pregnancy (6.7%±1.1% vs 6.5%±1.3% (50±12 mmol/mol vs 48±14 mmol/mol), p=0.32) and late pregnancy (5.9%±0.5% vs 6.0%±0.6% (41±6 mmol/mol vs 42±7 mmol/mol), p=0.34) were comparable in the two cohorts. LGA infants occurred in 20% vs 31%, p=0.07, respectively, and after adjustment for maternal characteristics 14% vs 27% delivered LGA infants (p=0.04). Birth weight z-score was 0.24±1.36 vs 0.61±1.38, p=0.06.ConclusionsMotivational interviewing to improve adherence to healthy eating in addition to routine care in pregnant women with type 2 diabetes tended to reduce fetal overgrowth without major effect on gestational weight gain. Further studies investigating the cost-benefit of enhancing motivation are needed.Trial registration numberNCT02883127.

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Gestational weight gain and incident type 2 diabetes in the daughter

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2006.10.833 ◽

2006 ◽

Vol 195 (6) ◽

pp. S228

Author(s):

Alison Stuebe ◽

Karin Michels

Keyword(s):

Type 2 Diabetes ◽

Weight Gain ◽

Gestational Weight Gain ◽

Incident Type ◽

Gestational Weight ◽

Incident Type 2 Diabetes

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Association among pre-pregnancy body mass index, gestational weight gain and neonatal birth weight: a prospective cohort study in China

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03323-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yawen Wang ◽

Haihui Ma ◽

Yahui Feng ◽

Yongle Zhan ◽

Sansan Wu ◽

...

Keyword(s):

Body Mass Index ◽

Weight Gain ◽

Birth Weight ◽

Gestational Weight Gain ◽

Body Mass ◽

Gestational Age ◽

Chinese Women ◽

Response Analysis ◽

Gestational Weight ◽

Neonatal Birth Weight

Abstract Background This study aims to explore the relationships between pre-pregnancy body mass index (BMI), gestational weight gain (GWG), rate of GWG during the second and third trimesters (GWGrate) and birth weight among Chinese women. Methods Women were enrolled by 24 hospitals in 15 different provinces in mainland China from July 25th, 2017 to 26 November 2018. Pre-pregnancy BMI, GWG and GWGrate were calculated and divided in to different groups. The multinomial logistic regression model and restrictive cubic spline model were used to explore the relationships. Results Of the 3585 participants, women who were underweight, had insufficient GWG or GWGrate had 1.853-, 1850- or 1.524-fold higher risks for delivering small-for-gestational-age (SGA) infant compared with women who had normal BMI, sufficient GWG or GWGrate. Women who were overweight/obese, had excessive GWG or GWGrate had 1.996-, 1676- or 1.673-fold higher risks for delivering large-for-gestational-age (LGA) infant. The effects of GWG and GWGrate on birth weight varied by pre-pregnancy BMI statuses. Dose-response analysis demonstrated L-shaped and S-shaped relationships between pre-pregnancy BMI, GWG, GWGrate and neonatal birth weight. Conclusions Pre-pregnancy BMI, GWG or GWGrate were associated with neonatal birth weight among Chinese women. Both body weight before and during pregnancy should be maintained within the recommendations to prevent abnormal birth weight.

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Leptin and Ghrelin in Excessive Gestational Weight Gain—Association between Mothers and Offspring

International Journal of Molecular Sciences ◽

10.3390/ijms20102398 ◽

2019 ◽

Vol 20 (10) ◽

pp. 2398 ◽

Cited By ~ 3

Author(s):

Jolanta Patro-Małysza ◽

Marcin Trojnar ◽

Katarzyna E. Skórzyńska-Dziduszko ◽

Żaneta Kimber-Trojnar ◽

Dorota Darmochwał-Kolarz ◽

...

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Gestational Weight Gain ◽

Body Length ◽

Head Circumference ◽

Maternal Serum ◽

Control Group ◽

Gestational Weight ◽

Neonatal Birth Weight ◽

Serum Ghrelin

Two-thirds of pregnant women exceed gestational weight gain recommendations. Excessive gestational weight gain (EGWG) appears to be associated with offspring’s complications induced by mechanisms that are still unclear. The aim of this study was to investigate whether umbilical cord leptin (UCL) and ghrelin (UCG) concentrations are altered in full-term neonates born to EGWG mothers and whether neonatal anthropometric measurements correlate with UCL and UCG levels and maternal serum ghrelin and leptin as well as urine ghrelin concentrations. The study subjects were divided into two groups, 28 healthy controls and 38 patients with EGWG. Lower UCL and UCG levels were observed in neonates born to healthy mothers but only in male newborns. In the control group UCG concentrations correlated positively with neonatal birth weight, body length and head circumference. In the control group maternal serum ghrelin levels correlated negatively with neonatal birth weight, body length and head circumference as well as positively with chest circumference. In the EGWG group UCG concentrations correlated negatively with neonatal birth weight and birth body length. UCL correlated positively with birth body length in EGWG group and negatively with head circumference in the control group. In conclusion, EGWG is associated with disturbances in UCL and UCG concentrations.

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Interprovincial variation in pre-pregnancy body mass index and gestational weight gain and their impact on neonatal birth weight with respect to small and large for gestational age

Can J Public Health ◽

10.17269/s41997-018-0086-x ◽

2018 ◽

Vol 109 (4) ◽

pp. 527-538 ◽

Cited By ~ 11

Author(s):

Sarah D. McDonald ◽

Christy Woolcott ◽

Núria Chapinal ◽

Yanfang Guo ◽

Phil Murphy ◽

...

Keyword(s):

Body Mass Index ◽

Weight Gain ◽

Birth Weight ◽

Gestational Weight Gain ◽

Body Mass ◽

Gestational Age ◽

Large For Gestational Age ◽

Gestational Weight ◽

Neonatal Birth Weight

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Gestational Weight Gain and Maternal and Neonatal Outcomes in Term Twin Pregnancies in Obese Women

Twin Research and Human Genetics ◽

10.1017/thg.2013.91 ◽

2014 ◽

Vol 17 (2) ◽

pp. 127-133 ◽

Cited By ~ 13

Author(s):

Jeffrey A. Gavard ◽

Raul Artal

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Cesarean Delivery ◽

Gestational Weight Gain ◽

Institute Of Medicine ◽

Obese Women ◽

Gestational Weight ◽

Maternal And Neonatal Outcomes ◽

Increasing Trends ◽

Twin Pregnancies

Limited data is available that estimates the effect of gestational weight gain on maternal and neonatal outcomes in term twin pregnancies in obese women. A historical cohort study of 831 obese (BMI ≥30.0 kg/m2) women in Missouri delivering 1,662 liveborn, term (≥37 weeks gestation) twin infants in 1998–2005 was conducted. Three gestational weight gain categories were examined: <25 pounds, 25–42 pounds, and >42 pounds. Adjusted odds ratios were calculated with multiple logistic regression, using the 2009 Institute of Medicine provisional guideline of 25–42 pounds as the reference group. Significant increasing trends with gestational weight gain were found for preeclampsia (p < .05), larger twin birth weight (p < .01), smaller twin birth weight (p < .001), and infants weighing >2,500 grams (p < .001). Significant increasing trends for preeclampsia and for cesarean delivery were found in concordant twin pairs (smaller twin >80% of birth weight of larger twin). Women who gained >42 pounds had a borderline significantly higher odds of preeclampsia than women who gained 25–42 pounds (adjusted OR 1.72; 95% CI 1.00–2.99, p = .052). No significant differences were found for 1-min Apgar score <4, 5-min Apgar score <7, or infant mortality ≤1 year. Our study suggests that increasing gestational weight gain is associated with larger infants but increased risk of preeclampsia and cesarean delivery in term twin pregnancies in obese women. Limiting gestational weight gain could reduce the risk of preeclampsia and cesarean delivery. Prospective studies of other study populations and maternal/infant outcomes are needed to evaluate the efficacy of the Institute of Medicine guideline.

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Adolphe Quetelet’s Premonition Two Centuries after: Besides Its Implications in Physiology (Obesity, Type 2 Diabetes), Its Paramount Importance in Human Pregnancy

Journal of Diabetes Metabolism and its Complications ◽

10.31487/j.jdmc.2020.01.05 ◽

2020 ◽

pp. 1-3

Author(s):

Pierre-Yves Robillard ◽

Pierre-Yves Robillard

Keyword(s):

Type 2 Diabetes ◽

Body Mass Index ◽

Weight Gain ◽

Gestational Weight Gain ◽

Medical Science ◽

Historical Overview ◽

Gestational Weight ◽

In Pregnancy ◽

Quetelet Index

Adolphe Quételet (1796-1874) proposed in 1835 the “Quételet index”, which was re-discovered in 1972 by Keys et al. under the acronym “Body Mass index”, BMI. The author makes an historical overview of the evolution of this BMI and its interest in medical science and anthropometry. Nowadays this BMI appears to be involved in a mathematical linear law concerning the gestational weight gain in human pregnancies. Getting rid of the current fuzzy recommendations concerning the optimal weight gain for each woman in pregnancy, this may have paramount consequences for the future. When confirmed, Quételet’s proposal will appear as a further Copernician revolution in human anthropometry.

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