Low weight gain in women with gestational diabetes linked with better postpartum metabolic profile

In women with GDM, gestational weight gain below the guidelines by the Institute of Medicine (IOM) guidelines frequently occurs, with a better metabolic profile postpartum and without increased risk for adverse pregnancy outcomes.

Caro Minschart, Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Belgium, and colleagues designed a prospective cohort study to evaluate the association of gestational weight gain (GWG) as low, within, or above (excessive) according to the IOM guidelines, with pregnancy outcomes in women with gestational diabetes and normal glucose tolerance (NGT).

The study included 1843 women receiving universal GDM screening with a 75 g oral glucose tolerance test from 7 Belgian hospitals. The primary outcomes of the study were pregnancy outcomes and postpartum characteristics.

The study demonstrated the following findings:

• Women with gestational diabetes and low gestational weight gain (n = 97, 52.4%) had similar rates of small-for-gestational-age infants and preterm delivery, were less often overweight or obese postpartum [35.7% vs. 56.5%] and had less often postpartum weight retention (PPWR) [48.8% vs. 87.9%] compared to GWG within range (n = 58, 31.3%).
• GDM with excessive GWG (n = 30, 16.2%) had more often neonatal hypoglycemia [30.8% vs. 5.9%, aOR 7.15] compared to GWG within range.
• Normal glucose tolerance with excessive GWG [28.3%] had more often instrumental delivery [15.9% vs. 11.9%, aOR 1.53] and more large-for-gestational age infants [19.3% vs. 10.4%, aOR 1.67] compared to GWG within range.

"In GDM women, gestational weight gain below IOM guidelines frequently occurred, with better metabolic profile postpartum and without increased risk for adverse pregnancy outcomes," the researchers wrote in their conclusion. "Excessive GWG was associated with higher risk for neonatal hypoglycemia and worse metabolic profile postpartum in GDM women, and with higher rates of instrumental delivery and large for gestational age (LGA)."

Reference:

Caro Minschart, Astrid Lammertyn, Paul Van Crombrugge, Carolien Moyson, Johan Verhaeghe, Sofie Vandeginste, Hilde Verlaenen, Chris Vercammen, Toon Maes, Els Dufraimont, Nele Roggen, Christophe De Block, Yves Jacquemyn, Farah Mekahli, Katrien De Clippel, Annick Van Den Bruel, Anne Loccufier, Annouschka Laenen, Roland Devlieger, Chantal Mathieu, Katrien Benhalima, Low gestational weight gain in women with gestational diabetes is safe with better metabolic profile postpartum, The Journal of Clinical Endocrinology & Metabolism, 2022;, dgac599, https://doi.org/10.1210/clinem/dgac599