Maternal and Child Health Journal

, Volume 18, Issue 5, pp 1265–1270 | Cite as

Gestational Weight Gain, Early Pregnancy Maternal Adiposity Distribution, and Maternal Hyperglycemia

  • Laura E. Tomedi
  • Hyagriv N. Simhan
  • Chung-Chou H. Chang
  • Kathleen M. McTigue
  • Lisa M. Bodnar
Article

Abstract

To estimate the effects of gestational weight gain (GWG), central adiposity and subcutaneous fat on maternal post-load glucose concentration, pregnant women [n = 413, 62 % black, 57 % with pregravid body mass index (BMI) ≥25] enrolled in a cohort study at ≤13 weeks gestation. GWG was abstracted from medical records. In a sub-sample of women (n = 214), waist circumference (WC), and biceps and triceps skinfold thicknesses were measured at enrollment. At 24–28 weeks gestation, post-load glucose concentration was measured using a 50-g 1-h oral glucose tolerance test. After adjustment for pre-pregnancy BMI, age, parity, race/ethnicity, smoking, marital status, annual family income, education, family history of diabetes, and gestational age of GDM screening, each 0.3-kg/week increase in weight in the first trimester was associated with a 2.2 (95 % CI 0.1, 4.3)-mg/dl increase in glucose concentration. Each 8.6-mm increase in biceps skinfold thickness and each 11.7-mm increase in triceps skinfold thickness was associated with 4.3 (95 % CI 0.2, 8.5)-mg/dl increase in maternal glucose, independent of BMI and other confounders. Neither GWG in the second trimester nor WC at ≤13 weeks was significantly associated with glucose concentration after confounder adjustment. Independent of pre-pregnancy BMI, high early pregnancy GWG and maternal subcutaneous body fat may be positively associated with maternal glucose concentrations at 24–28 weeks.

Keywords

Gestational weight gain Skinfold thickness Pregnancy Glucose Gestational diabetes 

Notes

Acknowledgments

This research was funded by the National Institutes of Health NIH Grant R01 HD052732 (PI: Simhan) and the Reproductive, Perinatal and Pediatric Epidemiology Grant HD 055 162-03 NIH NRSA T32 (NICHD).

References

  1. 1.
    Metzger, B. E., Lowe, L. P., Dyer, A. R., Trimble, E. R., Chaovarindr, U., Coustan, D. R., et al. (2008). Hyperglycemia and adverse pregnancy outcomes. New England Journal of Medicine, 358(19), 1991–2002.PubMedCrossRefGoogle Scholar
  2. 2.
    Morikawa, M., Yamada, T., Sato, S., Cho, K., & Minakami, H. (2012). Prevalence of hyperglycemia during pregnancy according to maternal age and pre-pregnancy body mass index in Japan, 2007–2009. International Journal of Gynecology & Obstetrics, 118(3), 198–201.CrossRefGoogle Scholar
  3. 3.
    Chu, S. Y., Callaghan, W. M., Kim, S. Y., Schmid, C. H., Lau, J., England, L. J., et al. (2007). Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care, 30(8), 2070–2076.PubMedCrossRefGoogle Scholar
  4. 4.
    Romero-Corral, A., Somers, V. K., Sierra-Johnson, J., Thomas, R. J., Collazo-Clavell, M. L., Korinek, J., et al. (2008). Accuracy of body mass index in diagnosing obesity in the adult general population. International Journal of Obesity (London), 32(6), 959–966.CrossRefGoogle Scholar
  5. 5.
    Kaess, B. M., Pedley, A., Massaro, J. M., Murabito, J., Hoffmann, U., & Fox, C. S. (2012). The ratio of visceral to subcutaneous fat, a metric of body fat distribution, is a unique correlate of cardiometabolic risk. Diabetologia, 55(10), 2622–2630.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Yilmaz, O., Kucuk, M., Ilgin, A., & Dagdelen, M. (2010). Assessment of insulin sensitivity/resistance and their relations with leptin concentrations and anthropometric measures in a pregnant population with and without gestational diabetes mellitus. Journal of Diabetes and Its Complications, 24(2), 109–114.PubMedCrossRefGoogle Scholar
  7. 7.
    Hedderson, M. M., Gunderson, E. P., & Ferrara, A. (2010). Gestational weight gain and risk of gestational diabetes mellitus. Obstetrics and Gynecology, 115(3), 597–604.PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Yeung, E. H., Hu, F. B., Solomon, C. G., Chen, L., Louis, G. M., Schisterman, E., et al. (2010). Life-course weight characteristics and the risk of gestational diabetes. Diabetologia, 53(4), 668–678.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Branchtein, L., Schmidt, M. I., Mengue, S. S., Reichelt, A. J., Matos, M. C., & Duncan, B. B. (1997). Waist circumference and waist-to-hip ratio are related to gestational glucose tolerance. Diabetes Care, 20(4), 509–511.PubMedCrossRefGoogle Scholar
  10. 10.
    Wendland, E. M., Duncan, B. B., Mengue, S. S., Nucci, L. B., & Schmidt, M. I. (2007). Waist circumference in the prediction of obesity-related adverse pregnancy outcomes. Cadernos de Saúde Pública, 23(2), 391–398.PubMedCrossRefGoogle Scholar
  11. 11.
    Carpenter, M. W., & Coustan, D. R. (1982). Criteria for screening tests for gestational diabetes. American Journal of Obstetrics and Gynecology, 144(7), 768–773.PubMedGoogle Scholar
  12. 12.
    Rasmussen, K. M., Yaktine, A. L., & Institute of Medicine (U.S.). (2009). Committee to reexamine IOM pregnancy weight guidelines. Weight gain during pregnancy: Reexamining the guidelines. Washington, DC: National Academies Press.Google Scholar
  13. 13.
    Bodnar, L. M., Siega-Riz, A. M., Simhan, H. N., Himes, K. P., & Abrams, B. (2010). Severe obesity, gestational weight gain, and adverse birth outcomes. The American Journal of Clinical Nutrition, 91(6), 1642–1648.PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    Laraia, B. A., Siega-Riz, A. M., & Gundersen, C. (2010). Household food insecurity is associated with self-reported pregravid weight status, gestational weight gain, and pregnancy complications. Journal of the American Dietetic Association, 110(5), 692–701.PubMedCentralPubMedCrossRefGoogle Scholar
  15. 15.
    NHLBI Obesity Education Initiative Expert Panel on the Identification, Evaluation, and Treatment of Obesity in Adults (US). (1998). Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report. National Institutes of Health. Obesity Research 6(Suppl 2), 51S–209S.Google Scholar
  16. 16.
    McCarthy, E. A., Strauss, B. J., Walker, S. P., & Permezel, M. (2004). Determination of maternal body composition in pregnancy and its relevance to perinatal outcomes. Obstetrical & Gynecological Survey, 59(10), 731–742. (quiz 45-6).CrossRefGoogle Scholar
  17. 17.
    Klein, S., Allison, D. B., Heymsfield, S. B., Kelley, D. E., Leibel, R. L., Nonas, C., et al. (2007). Waist circumference and cardiometabolic risk: A consensus statement from shaping America’s health: Association for Weight Management and Obesity Prevention; NAASO, the Obesity Society; the American Society for Nutrition; and the American Diabetes Association. Obesity (Silver Spring), 15(5), 1061–1067.CrossRefGoogle Scholar
  18. 18.
    Sievenpiper, J. L., Jenkins, D. J., Josse, R. G., Leiter, L. A., & Vuksan, V. (2001). Simple skinfold-thickness measurements complement conventional anthropometric assessments in predicting glucose tolerance. The American Journal of Clinical Nutrition, 73(3), 567–573.PubMedGoogle Scholar
  19. 19.
    Herring, S. J., Oken, E., Rifas-Shiman, S. L., Rich-Edwards, J. W., Stuebe, A. M., Kleinman, K. P., et al. (2009). Weight gain in pregnancy and risk of maternal hyperglycemia. American Journal of Obstetrics and Gynecology, 201(1), 61e1–61e7.CrossRefGoogle Scholar
  20. 20.
    Gibson, K. S., Waters, T. P., & Catalano, P. M. (2012). Maternal weight gain in women who develop gestational diabetes mellitus. Obstetrics and Gynecology, 119(3), 560–565.PubMedCrossRefGoogle Scholar
  21. 21.
    Morisset, A. S., Tchernof, A., Dube, M. C., Veillette, J., Weisnagel, S. J., & Robitaille, J. (2011). Weight gain measures in women with gestational diabetes mellitus. Journal of Women’s Health (Larchmt), 20(3), 375–380.CrossRefGoogle Scholar
  22. 22.
    Harrison, C. L., Lombard, C. B., & Teede, H. J. (2012). Understanding health behaviours in a cohort of pregnant women at risk of gestational diabetes mellitus: An observational study. BJOG, 119(6), 731–738.PubMedCrossRefGoogle Scholar
  23. 23.
    Riskin-Mashiah, S., Damti, A., Younes, G., & Auslander, R. (2011). Pregestational body mass index, weight gain during pregnancy and maternal hyperglycemia. Gynecological Endocrinology, 27(7), 464–467.PubMedCrossRefGoogle Scholar
  24. 24.
    Tovar, A., Must, A., Bermudez, O. I., Hyatt, R. R., & Chasan-Taber, L. (2009). The impact of gestational weight gain and diet on abnormal glucose tolerance during pregnancy in Hispanic women. Maternal and Child Health Journal, 13(4), 520–530.PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Saldana, T. M., Siega-Riz, A. M., Adair, L. S., & Suchindran, C. (2006). The relationship between pregnancy weight gain and glucose tolerance status among black and white women in central North Carolina. American Journal of Obstetrics and Gynecology, 195(6), 1629–1635.PubMedCrossRefGoogle Scholar
  26. 26.
    Ioannidis, I. (2008). The road from obesity to type 2 diabetes. Angiology, 59(2 Suppl), 39S–43S.PubMedCrossRefGoogle Scholar
  27. 27.
    van Raaij, J. M., Peek, M. E., Vermaat-Miedema, S. H., Schonk, C. M., & Hautvast, J. G. (1988). New equations for estimating body fat mass in pregnancy from body density or total body water. The American Journal of Clinical Nutrition, 48(1), 24–29.PubMedGoogle Scholar
  28. 28.
    Goodpaster, B. H., Thaete, F. L., Simoneau, J. A., & Kelley, D. E. (1997). Subcutaneous abdominal fat and thigh muscle composition predict insulin sensitivity independently of visceral fat. Diabetes, 46(10), 1579–1585.PubMedCrossRefGoogle Scholar
  29. 29.
    Colomiere, M., Permezel, M., & Lappas, M. (2010). Diabetes and obesity during pregnancy alter insulin signalling and glucose transporter expression in maternal skeletal muscle and subcutaneous adipose tissue. Journal of Molecular Endocrinology, 44(4), 213–223.PubMedCrossRefGoogle Scholar
  30. 30.
    Gallagher, D., Kelley, D. E., Yim, J. E., Spence, N., Albu, J., Boxt, L., et al. (2009). Adipose tissue distribution is different in type 2 diabetes. The American Journal of Clinical Nutrition, 89(3), 807–814.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Laura E. Tomedi
    • 1
  • Hyagriv N. Simhan
    • 2
  • Chung-Chou H. Chang
    • 3
  • Kathleen M. McTigue
    • 1
    • 3
  • Lisa M. Bodnar
    • 1
    • 2
  1. 1.Department of EpidemiologyUniversity of Pittsburgh Graduate School of Public HealthPittsburghUSA
  2. 2.Department of Obstetrics, Gynecology, and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghUSA
  3. 3.Department of MedicineUniversity of Pittsburgh School of MedicinePittsburghUSA

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