Skip to main content
SpringerLink
Log in

Relation between weight gain during pregnancy and postpartum reclassification in gestational diabetes

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

Purpose

Gestational diabetes mellitus (GDM) is the most common metabolic disease in pregnancy. It is known that GDM is a precursor to type 2 diabetes (T2D). There is evidence that excessive gestational weight variation (GWV) increases the risk of GDM. So, in this study, we aimed to evaluate the association between GWV and the persistence of diabetes in postpartum reclassification.

Methods

A retrospective observational study including pregnant women based on data from the Portuguese National Registry of Gestational Diabetes. Six-to-eight weeks after delivery, all women included underwent a reclassification test. We performed unadjusted and adjusted logistic regression models to evaluate the associations between GWV and diabetes diagnosis at the reclassification test. A subgroup analysis according to the pre-gestational BMI was also performed.

Results

We included 10,389 pregnant women, of which 19.6% had GDM in a previous pregnancy. The median of GWV was 10.0 [6.4, 14.0] kg and was found to be higher for those with a normal BMI. At the DM reclassification test, 1% of the women were diagnosed with T2D. We found a negative association between GWV and postpartum diabetes mellitus (DM). We also present a subgroup analysis, and these associations were only significant for the group with a normal pre-gestational BMI.

Conclusion

Our results showed that women with normal pre-gestational BMI and lower GWV were more likely to have a diagnosis of DM in the postpartum reclassification test. This study helps to fill the gap in the effect of GWG on the persistence of diabetes in postpartum reclassification.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References The attached version has 31 references.

  1. A.A. Choudhury, V. Devi Rajeswari, Gestational diabetes mellitus—a metabolic and reproductive disorder. Biomed. Pharmacother. 143, 112183 (2021). https://doi.org/10.1016/j.biopha.2021.112183

    Article  CAS  PubMed  Google Scholar 

  2. L.T. Dickens, C.C. Thomas, Updates in gestational diabetes prevalence, treatment, and health policy. Curr. Diab. Rep. 19(6), 33 (2019). https://doi.org/10.1007/s11892-019-1147-0

    Article  PubMed  Google Scholar 

  3. M.S. Paulo, N.M. Abdo, R. Bettencourt-Silva, R.H. Al-Rifai, Gestational diabetes mellitus in Europe: a systematic review and meta-analysis of prevalence studies. Front. Endocrinol. (Lausanne) 12, 691033 (2021). https://doi.org/10.3389/fendo.2021.691033

    Article  PubMed  Google Scholar 

  4. J.F. Plows, J.L. Stanley, P.N. Baker, C.M. Reynolds, M.H. Vickers, The pathophysiology of gestational diabetes mellitus. Int. J. Mol. Sci. 19(11), 3342 (2018). https://doi.org/10.3390/ijms19113342

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. A. Sweeting, J. Wong, H.R. Murphy, G.P. Ross, A clinical update on gestational diabetes mellitus. Endocr. Rev. 43(5), 763–793 (2022). https://doi.org/10.1210/endrev/bnac003

    Article  PubMed  PubMed Central  Google Scholar 

  6. H. Wang, N. Li, T. Chivese, M. Werfalli, H. Sun, L. Yuen, C.A. Hoegfeldt, C. Elise Powe, J. Immanuel, S. Karuranga, H. Divakar, N. Levitt, C. Li, D. Simmons, X. Yang; Group, I.D.F.D.A.C.H.i.P.S.I.: IDF Diabetes Atlas: Estimation of Global and Regional Gestational Diabetes Mellitus Prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group’s Criteria. Diabetes Res. Clin. Pract. 183, 109050 (2022). https://doi.org/10.1016/j.diabres.2021.109050

    Article  PubMed  Google Scholar 

  7. P. Chen, S. Wang, J. Ji, A. Ge, C. Chen, Y. Zhu, N. Xie, Y. Wang, Risk factors and management of gestational diabetes. Cell Biochem. Biophys. 71(2), 689–694 (2015). https://doi.org/10.1007/s12013-014-0248-2

    Article  CAS  PubMed  Google Scholar 

  8. J.H. Moon, H.C. Jang, Gestational diabetes mellitus: diagnostic approaches and maternal-offspring complications. Diabetes Metab. J. 46(1), 3–14 (2022). https://doi.org/10.4093/dmj.2021.0335

    Article  PubMed  PubMed Central  Google Scholar 

  9. B. Baz, J.P. Riveline, J.F. Gautier, Endocrinology of pregnancy: gestational diabetes mellitus: definition, aetiological and clinical aspects. Eur. J. Endocrinol. 174(2), R43–R51 (2016). https://doi.org/10.1530/EJE-15-0378

    Article  CAS  PubMed  Google Scholar 

  10. Y. Zhu, C. Zhang, Prevalence of gestational diabetes and risk of progression to type 2 diabetes: a global perspective. Curr. Diab. Rep. 16(1), 7 (2016). https://doi.org/10.1007/s11892-015-0699-x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. F.L. Alvarado, P. O’Tierney-Ginn, P. Catalano, Contribution of gestational weight gain on maternal glucose metabolism in women with gdm and normal glucose tolerance. J. Endocr. Soc. 5(2), bvaa195 (2021). https://doi.org/10.1210/jendso/bvaa195

    Article  CAS  PubMed  Google Scholar 

  12. J.H. Moon, S.H. Kwak, H.S. Jung, S.H. Choi, S. Lim, Y.M. Cho, K.S. Park, H.C. Jang, N.H. Cho, Weight gain and progression to type 2 diabetes in women with a history of gestational diabetes mellitus. J. Clin. Endocrinol. Metab. 100(9), 3548–3555 (2015). https://doi.org/10.1210/JC.2015-1113

    Article  CAS  PubMed  Google Scholar 

  13. E. Chiefari, B. Arcidiacono, D. Foti, A. Brunetti, Gestational diabetes mellitus: an updated overview. J Endocrinol. Invest. 40(9), 899–909 (2017). https://doi.org/10.1007/s40618-016-0607-5

    Article  CAS  PubMed  Google Scholar 

  14. V.E. Whiteman, M.H. Aliyu, E.M. August, C. McIntosh, J. Duan, A.P. Alio, H.M. Salihu, Changes in prepregnancy body mass index between pregnancies and risk of gestational and type 2 diabetes. Arch. Gynecol. Obstet. 284(1), 235–240 (2011). https://doi.org/10.1007/s00404-011-1917-7

    Article  PubMed  Google Scholar 

  15. J.A. Laredo-Aguilera, M. Gallardo-Bravo, J.A. Rabanales-Sotos, A.I. Cobo-Cuenca, J.M. Carmona-Torres, Physical activity programs during pregnancy are effective for the control of gestational diabetes mellitus. Int. J. Environ. Res. Public Health 17(17), 6151 (2020). https://doi.org/10.3390/ijerph17176151

    Article  PubMed  PubMed Central  Google Scholar 

  16. K.K. Vesco, P.M. Dietz, J. Rizzo, V.J. Stevens, N.A. Perrin, D.J. Bachman, W.M. Callaghan, F.C. Bruce, M.C. Hornbrook (eds.), Excessive Gestational Weight Gain and Postpartum. (2009)

  17. American Diabetes Association Professional Practice, C.: 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. Diabetes Care 45 (Suppl 1), S17–S38 (2022). https://doi.org/10.2337/dc22-S002

  18. Institute of, M., National Research Council Committee to Reexamine, I.O.M.P.W.G.: The National Academies Collection: Reports funded by National Institutes of Health. in Weight Gain During Pregnancy: Reexamining the Guidelines, ed. byK.M. Rasmussen, A.L. Yaktine. (National Academies Press, US, Copyright © 2009, National Academy of Sciences, Washington, DC, 2009)

  19. D. Cwiek, A. Lubkowska, M. Zimny, K. Szymoniak, O. Sipak-Szmigiel, Weight gain during and after pregnancy in women with gestational diabetes mellitus—a preliminary study. Int. J. Environ. Res. Public Health 19(19), 11959 (2022). https://doi.org/10.3390/ijerph191911959

    Article  PubMed  PubMed Central  Google Scholar 

  20. C. Matta-Coelho, A.M. Monteiro, V. Fernandes, M.L. Pereira, D. Portuguese, Pregnancy Study, G., Souto, S.B.: Universal vs. risk-factor-based screening for gestational diabetes-an analysis from a 5-Year Portuguese Cohort. Endocrine 63(3), 507–512 (2019). https://doi.org/10.1007/s12020-018-1760-8

    Article  CAS  PubMed  Google Scholar 

  21. Maria do Céu Almeida JDeLR: Consenso diabetes gestacional. Revista Portuguesa de Diabetes. 2017;12:24-38

  22. H.C. Jang, C.H. Yim, K.O. Han, H.K. Yoon, I.K. Han, M.Y. Kim, J.H. Yang, N.H. Cho, Gestational diabetes mellitus in Korea: prevalence and prediction of glucose intolerance at early postpartum. Diabetes Res. Clin. Pract. 61(2), 117–124 (2003). https://doi.org/10.1016/s0168-8227(03)00110-4

    Article  CAS  PubMed  Google Scholar 

  23. E.K. Berggren, S. Groh-Wargo, L. Presley, S. Hauguel-de Mouzon, P.M. Catalano, Maternal fat, but not lean, mass is increased among overweight/obese women with excess gestational weight gain. Am. J. Obstet. Gynecol. 214(6), 745 e741–7745 (2016). https://doi.org/10.1016/j.ajog.2015.12.026

    Article  Google Scholar 

  24. K.L. Gray, L.M. McKellar, S.L. O’Reilly, P.M. Clifton, J.B. Keogh, Women’s barriers to weight loss, perception of future diabetes risk and opinions of diet strategies following gestational diabetes: an online survey. Int. J. Environ. Res. Public Health 17(24), 9180 (2020). https://doi.org/10.3390/ijerph17249180

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. E. Huvinen, J. Lahti, M.M. Klemetti, P.H. Bergman, K. Raikkonen, M. Orho-Melander, H. Laivuori, S.B. Koivusalo, Genetic risk of type 2 diabetes modifies the effects of a lifestyle intervention aimed at the prevention of gestational and postpartum diabetes. Diabetologia 65(8), 1291–1301 (2022). https://doi.org/10.1007/s00125-022-05712-7

    Article  PubMed  PubMed Central  Google Scholar 

  26. S.A. Leonard, B. Abrams, E.K. Main, D.J. Lyell, S.L. Carmichael, Weight gain during pregnancy and the risk of severe maternal morbidity by prepregnancy BMI. Am J Clin Nutr 111(4), 845–853 (2020). https://doi.org/10.1093/ajcn/nqaa033

    Article  PubMed  PubMed Central  Google Scholar 

  27. M. Lewandowska, Gestational diabetes mellitus (GDM) risk for declared family history of diabetes, in combination with BMI categories. Int. J. Environ. Res. Public Health 18(13), 6936 (2021). https://doi.org/10.3390/ijerph18136936

    Article  PubMed  PubMed Central  Google Scholar 

  28. H. Soltani, N.I. Lipoeto, F.J. Fair, K. Kilner, Y. Yusrawati, Pre-pregnancy body mass index and gestational weight gain and their effects on pregnancy and birth outcomes: a cohort study in West Sumatra, Indonesia. BMC Womens Health 17(1), 102 (2017). https://doi.org/10.1186/s12905-017-0455-2

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Diabetes and Pregnancy Study Group of the Portuguese Society of Diabetology

Maria do Céu Ameida6

Author information

Authors and Affiliations

  1. Department of Biomedicins, Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal

    Sofia Coelho

  2. Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal

    Marta Canha, Ana Rita Leite & João Sérgio Neves

  3. Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal

    Marta Canha, Ana Rita Leite & João Sérgio Neves

  4. Hospital de Santa Maria, Porto, Portugal

    Ana Isabel Oliveira

  5. Instituto de Investigação e Inovação em Saúde (i3s), Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal

    Davide Carvalho

  6. Obstetrics Department, Maternidade Bissaya Barreto, Rua Augusta 36, 3000-045, Porto, Portugal

    Maria do Céu Ameida

Authors
  1. Sofia Coelho
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marta Canha
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ana Rita Leite
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. João Sérgio Neves
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ana Isabel Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Davide Carvalho
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

Diabetes and Pregnancy Study Group of the Portuguese Society of Diabetology

  • Maria do Céu Ameida

Contributions

S.C. and M.B.C. conceived and designed the study. S.C., M.B.C., J.S.N., A.R.L., D.C., and A.I.O. provided methodological and statistical advice. S.C. and M.B.C. drafted the first version of the paper. All authors provided clinical feedback in interpreting the results, contributed critically to subsequent revisions, and approved the final version of the paper.

Corresponding author

Correspondence to Sofia Coelho.

Ethics declarations

Ethics approval

The present study was accepted by the ethical committee of Centro Hospitalar e Universitário São João (CHUSJ) in Oporto (128-22). The dataset for this study is available from the Portuguese National Registry of Gestational Diabetes on reasonable request, and we received ethical approval from the Diabetes and Pregnancy Study Group of the Portuguese Society of Diabetology.

Consent to participate

It is not necessary to provide any informed consent for participation in accordance with the national legislation and the institutional requirements. The privacy of the patients was guaranteed in this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Coelho, S., Canha, M., Leite, A.R. et al. Relation between weight gain during pregnancy and postpartum reclassification in gestational diabetes. Endocrine 82, 296–302 (2023). https://doi.org/10.1007/s12020-023-03441-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-023-03441-4

Keywords

Search

Navigation