American Journal of Obstetrics & Gynecology
Volume 201, Issue 1 , Pages 61.e1-61.e7 , July 2009

Weight gain in pregnancy and risk of maternal hyperglycemia

Presented at the Annual Scientific Meeting of the Society for Pediatric and Perinatal Epidemiologic Research, Chicago, IL, June 23-24, 2008.

  • Sharon J. Herring, MD, MPH

      Affiliations

    • Center for Obesity Research and Education, Temple University School of Medicine, Philadelphia, PA
    • Corresponding Author InformationReprints: Sharon J. Herring, MD, MPH, Center for Obesity Research and Education, Temple University School of Medicine, 3223 N. Broad St., Suite 175, Philadelphia, PA 19140
  • ,
  • Emily Oken, MD, MPH

      Affiliations

    • Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA
  • ,
  • Sheryl L. Rifas-Shiman, MPH

      Affiliations

    • Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA
  • ,
  • Janet W. Rich-Edwards, ScD

      Affiliations

    • Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA
  • ,
  • Alison M. Stuebe, MD, MSc

      Affiliations

    • Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC
  • ,
  • Ken P. Kleinman, ScD

      Affiliations

    • Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA
  • ,
  • Matthew W. Gillman, MD, SM

      Affiliations

    • Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA
    • Department of Nutrition, Harvard School of Public Health, Boston, MA

Received 16 August 2008 ,Revised 25 November 2008 ,Accepted 21 January 2009.

References 

  1. American Diabetes Association. Standards of medical care in diabetes—2008. Diabetes Care. 2008;31(suppl):S13–S54
  2. American College of Obstetricians and Gynecologists. Gestational diabetes: ACOG Practice Bulletin No.: 30. Obstet Gynecol. 2001;98:525–538
  3. Oken E, Gillman MW. Fetal origins of obesity. Obes Res. 2003;11:496–506
  4. Ogata ES. Perinatal morbidity in offspring of diabetic mothers. Diabetes Rev. 1995;3:652–657
  5. Sermer M, Naylor CD, Farine D, et al. The Toronto Tri-Hospital Gestational Diabetes project: a preliminary review. Diabetes Care. 1998;21:B33–B42
  6. Gunderson EP, Lewis CE, Tsai AL, et al. A 20-year prospective study of childbearing and incidence of diabetes in young women, controlling for glycemia before conception: the Coronary Artery Risk Development in Young Adults (CARDIA) study. Diabetes. 2007;56:2990–2996
  7. Dabelea D, Pettitt DJ. Intrauterine diabetic environment confers risks for type 2 diabetes mellitus and obesity in the offspring, in addition to genetic susceptibility. J Pediatr Endocrinol Metab. 2001;14:1085–1091
  8. Hillier TA, Pedula KL, Schmidt MM, Mullen JA, Charles MA, Pettitt DJ. Childhood obesity and metabolic imprinting. Diabetes Care. 2007;30:2287–2292
  9. Tallarigo L, Giampietro O, Penno G, Miccoli R, Gregori G, Navalesi R. Relation of glucose tolerance to complications of pregnancy in nondiabetic women. N Engl J Med. 1986;315:989–992
  10. Sermer M, Naylor CD, Gare DJ, et al. Impact of increasing carbohydrate intolerance on maternal-fetal outcomes in 3637 women without gestational diabetes. Am J Obstet Gynecol. 1995;173:146–156
  11. Langer O, Brustman L, Anyaegbunam A, Mazze R. The significance of one abnormal glucose tolerance test value on adverse outcome in pregnancy. Am J Obstet Gynecol. 1987;157:758–763
  12. The HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358:1991–2002
  13. Crowther CA, Hiller JE, Moss JR, et al. Effect of treatment of gestational diabetes on pregnancy outcomes. N Engl J Med. 2005;352:2477–2486
  14. Ferrara A, Kahn HS, Quesenberry C, Riley C, Hedderson MM. An increase in incidence of gestational diabetes mellitus: northern California, 1991-2000. Obstet Gynecol. 2004;103:526–533
  15. Chu SY, Callaghan WM, Kim SY, et al. Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care. 2007;30:2070–2076
  16. Solomon CG, Willett WC, Carey VJ, et al. A prospective study of pregravid determinants of gestational diabetes mellitus. JAMA. 1997;278:1078–1083
  17. Hedderson MM, Williams MA, Holt VL, Weiss NS, Ferrara A. Body mass index and weight gain prior to pregnancy and risk of gestational diabetes mellitus. Am J Obstet Gynec. 2008;198:409.e1–409.e7
  18. Rudra CB, Sorensen TK, Leisenring WM, Dashow E, Williams MA. Weight characteristics and height in relation to risk of gestational diabetes mellitus. Am J Epidemiol. 2007;165:302–308
  19. Villamor E, Cnattingius S. Interpregnancy weight change and risk of adverse pregnancy outcomes: a population-based study. Lancet. 2006;368:1164–1170
  20. Reaven GM. Role of insulin resistance in human disease. Diabetes. 1988;37:1595–1607
  21. Felber JP, Acheson KJ, Tappy L. From obesity to diabetes. New York: John Wiley & Sons; 1993;
  22. Rondinone CM. Adipocyte-derived hormones, cytokines, and mediators. Endocrine. 2006;29:81–90
  23. Gunderson EP, Sternfeld B, Wellons MF, et al. Childbearing may increase visceral adipose tissue independent of overall increase in body fat. Obesity. 2008;16:1078–1084
  24. Hytten FE, Leitch I. The physiology of pregnancy. 2nd ed.. Oxford, UK: Blackwell Scientific Publications; 1971;
  25. Institute of Medicine. Nutrition during pregnancy. Washington, DC: National Academy Press; 1990;
  26. Dahlgren J. Pregnancy and insulin resistance. Metab Syndr Relat Disord. 2006;4:149–152
  27. Saldana TM, Siega-Riz AM, Adair LS, Suchindran C. The relationship between pregnancy weight gain and glucose tolerance status among black and white women in central North Carolina. Am J Obstet Gynecol. 2006;195:1629–1635
  28. Wolff S, Legarth J, Vangsgaard K, Toubro S, Astrup A. A randomized trial of the effects of dietary counseling on gestational weight gain and glucose metabolism in obese pregnant women. Int J Obes. 2008;32:495–501
  29. Oken E, Taveras EM, Kleinman KP, Rich-Edwards JW, Gillman MW. Gestational weight gain and child adiposity at age 3 years. Am J Obstet Gynecol. 2007;196:322.e1–322.e8
  30. Gillman MW, Rich-Edwards JW, Rifas-Shiman SL, Lieberman ES, Kleinman KP, Lipsultz SE. Maternal age and other predictors of newborn blood pressure. J Pediatr. 2004;144:240–245
  31. World Medical Association declaration of Helsinki. Recommendations guiding physicians in biomedical research involving human subjects. JAMA. 1997;277:925–926
  32. Retnakaran R, Qi Y, Sermer M, Connelly PW, Hanley AJ, Zinman B. Glucose intolerance in pregnancy and future risk of pre-diabetes or diabetes. Diabetes Care. 2008;31:2026–2031
  33. Ju H, Rumbold AR, Willson KJ, Crowther CA. Borderline gestational diabetes mellitus and pregnancy outcomes. BMC Pregnancy Childbirth. 2008;8:31
  34. World Heath Organization. Obesity: preventing and managing the global epidemic: WHO technical report series 894. Geneva, Switzerland: World Health Organization; 2000;
  35. Oken E, Ning Y, Rifas-Shiman SL, Radesky JS, Rich-Edwards JW, Gillman MW. Associations of physical activity and inactivity before and during pregnancy with glucose tolerance. Obstet Gynecol. 2006;108:1200–1207
  36. Stuebe A, Oken E, Rich-Edwards JW, Gillman MW. Associations of diet and physical activity during pregnancy with risk for excessive gestational weight gain. Am J Obstet Gynecol. 2007;197(suppl):82
  37. Radesky JS, Oken E, Rifas-Shiman SL, Kleinman KP, Rich-Edwards JW, Gillman MW. Diet during early pregnancy and development of gestational diabetes. Paediatr Perinat Epidemiol. 2008;22:47–59
  38. Agresti A. Categorical data analysis. Hoboken, NJ: John Wiley & Sons; 2002;
  39. Siega-Riz AM, Adair LS, Hobel CJ. Institute of Medicine maternal weight gain recommendations and pregnancy outcome in a predominantly Hispanic population. Obstet Gynecol. 1994;84:565–573
  40. Tovar A, Must A, Bermudez OI, Hyatt RR, Chasan-Taber L. The impact of gestational weight gain and diet on abnormal glucose tolerance during pregnancy in Hispanic women. Matern Child Health J. 2008;Epub ahead of print
  41. Colditz GA, Willett WC, Rotnitzky A, Manson JE. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med. 1995;122:481–486
  42. Ford ES, Williamson DF, Liu S. Weight change and diabetes incidence: findings from a national cohort of US adults. Am J Epidemiol. 1997;146:214–222
  43. Hanson RL, Narayan KM, McCance DR, et al. Rate of weight gain, weight fluctuation, and incidence of NIDDM. Diabetes. 1995;44:261–266
  44. Schwartz MW, Woods SC, Prote D, Seeley RJ, Baskin DJ. Central nervous system control of food intake. Nature. 2000;404:661–671
  45. Schwartz MW, Niswender KD. Adiposity signaling and biological defense against weight gain: absence of protection or central hormone resistance?. J Clin Endocrinol Metab. 2004;84:5889–5897
  46. Neel JV. Diabetes mellitus: a “thrifty'” genotype rendered detrimental by “progress”?. Am J Hum Genet. 1962;14:353–362
  47. Kahn SE. The importance of b-cell failure in the development and progression of type 2 diabetes. J Clin Endocrinol Metab. 2001;86:4047–4058
  48. Buchanan TA. Pancreatic b-cell defects in gestational diabetes: implications for the pathogenesis and prevention of type 2 diabetes. J Clin Endocrinol Metab. 2001;86:989–993
  49. Catalano PM, Roman NM, Tyzbir ED, Merritt AO, Driscoll P, Amini SB. Weight gain in women with gestational diabetes. Obstet Gynecol. 1993;81:523–528
  50. Kieffer EC, Tabaei BP, Carman WJ, Nolan GH, Guzman JR, Herman WH. The influence of maternal weight and glucose tolerance on infant birthweight in Latino mother-infant pairs. Am J Public Health. 2006;96:2201–2208
  51. Swinburn BA, Nyomba BL, Sadd MF, et al. Insulin resistance associated with lower rates of weight gain in Pima Indians. J Clin Invest. 1991;88:168–173
  52. Retnakaran R, Zinman B, Connelly PW, Sermer M, Hanley AJ. Impaired glucose tolerance of pregnancy is a heterogeneous metabolic disorder as defined by the glycemic response to the oral glucose tolerance test. Diabetes Care. 2006;29:57–62

 This study was supported by Grants from the National Institutes of Health (HD 34568, HD 64925, HL 68041), Harvard Medical School, and the Harvard Pilgrim Health Care Foundation. Dr Herring was supported by an institutional Ruth L. Kirschstein National Research Service Award (5 T32 HP11001-19) from the Health Resources and Services Administration and the Department of Ambulatory Care and Prevention at Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA.

 Cite this article as: Herring SJ, Oken E, Rifas-Shiman SL, et al. Weight gain in pregnancy and risk of maternal hyperglycemia. Am J Obstet Gynecol 2009;201:61.e1-7.

PII: S0002-9378(09)00105-7

doi: 10.1016/j.ajog.2009.01.039

American Journal of Obstetrics & Gynecology
Volume 201, Issue 1 , Pages 61.e1-61.e7 , July 2009