Weight Gain and Gestational Diabetes

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Weight gain between a woman’s first and second pregnancies is associated with a higher risk of gestational diabetes during the second pregnancy, according to a new study from the Kaiser Permanente Division of Research. Conversely, losing weight between pregnancies appears to reduce the risk of developing gestational diabetes, particularly in women who are overweight or obese to begin with.

Gestational diabetes, a type of diabetes that is first diagnosed during pregnancy, affects roughly 4% of all pregnancies in the United States. It typically develops during the second or third trimester and is most likely to affect women who are older than 25, are overweight, have a close family member with diabetes, or belong to an ethnic group at high risk for diabetes, including African-Americans, Asian-Americans, Hispanic Americans, and Native Americans. Women with gestational diabetes are at increased risk of giving birth to babies with respiratory problems or high birth weights and are at heightened risk of themselves developing Type 2 diabetes.

To determine the association between increases in body-mass index (a measure of a person’s weight in relation to his height) and the risk of developing gestational diabetes, researchers looked at 22,351 women over a 10-year period. They found that women who gained roughly 12 to 17 pounds between their first two pregnancies were more than twice as likely to develop gestational diabetes as women whose weight remained relatively stable (defined as a loss or gain of no more than 6 pounds). Women who gained approximately 18 pounds or more between their first and second pregnancies were more than three times as likely to develop gestational diabetes during their second pregnancy than women whose weight remained stable.

Women who lost more than 6 pounds between their first two pregnancies, on the other hand, cut their risk of developing gestational diabetes by roughly 50% compared to those whose weights remained stable. This effect was strongest in women who were overweight or obese during their first pregnancy. (The researchers suspect that women of normal weight who go on to develop gestational diabetes may be genetically susceptible to the condition, and therefore less able to reduce their risk through lifestyle changes.)

Lead study investigator Samantha Ehrlich noted that “Taken together, the results support the avoidance of gestational weight retention and postpartum weight gain to decrease the risk of [gestational diabetes] in a second pregnancy, as well as the promotion of postpartum weight loss in overweight or obese women, particularly those with a history of [gestational diabetes].”

For more information, read the article “Weight Gain Between First and Second Pregnancies Increases Woman’s Gestational Diabetes Risk, Study Finds” or see the study’s abstract in the journal Obstetrics and Gynecology.

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