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Interpregnancy weight gain and cesarean delivery risk in women with a history of gestational diabetes.
Obstet Gynecol 2009; 113(4):817-23OG

Abstract

OBJECTIVE

Along with the rising prevalence of obesity, rates of gestational diabetes mellitus (GDM) and associated adverse outcomes also have increased. We conducted a population-based, retrospective cohort study to assess the association of weight gain between pregnancies with cesarean delivery for the subsequent pregnancy among women with a history of GDM.

METHODS

Using linked birth-certificate data for women with at least two singleton births in Washington State during the period from 1992-2005, we identified 2,753 women with GDM who delivered vaginally at the baseline pregnancy (first pregnancy on record). The interpregnancy weight change (subsequent-baseline prepregnancy weight) for each woman was calculated and assigned to one of three categories: weight loss (more than 10 lb), weight stable (+/-10 lb), or weight gain (more than 10 lb). Multiple logistic regression was used to calculate the risk (odds ratio [OR]) of cesarean delivery at the subsequent pregnancy among the weight-gain and weight-loss groups relative to the weight-stable category.

RESULTS

Among 2,581 eligible women, 10.9% lost more than 10 lb between pregnancies, 54.0% were weight-stable, and 35.1% gained more than 10 lb. Women who gained more than 10 lb had an adjusted OR for subsequent cesarean delivery of 1.70 (95% confidence interval [CI] 1.16-2.49, 9.7% of women who gained weight), whereas the adjusted OR for women who lost weight was 0.55 (95% CI 0.28-1.10, 4.7% of women who lost weight).

CONCLUSION

Women with a history of GDM who gained more than 10 lb between pregnancies are at increased risk of future cesarean delivery. Appropriate weight management among women with a history of GDM may result in decreased cesarean delivery rates along with decreases in associated excess risks and costs.

LEVEL OF EVIDENCE

II.

Authors+Show Affiliations

Department of Internal Medicine, Division of Cardiology, University of Washington, Seattle, Washington 98108, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

19305325

Citation

Paramsothy, Pathmaja, et al. "Interpregnancy Weight Gain and Cesarean Delivery Risk in Women With a History of Gestational Diabetes." Obstetrics and Gynecology, vol. 113, no. 4, 2009, pp. 817-23.
Paramsothy P, Lin YS, Kernic MA, et al. Interpregnancy weight gain and cesarean delivery risk in women with a history of gestational diabetes. Obstet Gynecol. 2009;113(4):817-23.
Paramsothy, P., Lin, Y. S., Kernic, M. A., & Foster-Schubert, K. E. (2009). Interpregnancy weight gain and cesarean delivery risk in women with a history of gestational diabetes. Obstetrics and Gynecology, 113(4), pp. 817-23. doi:10.1097/AOG.0b013e31819b33ac.
Paramsothy P, et al. Interpregnancy Weight Gain and Cesarean Delivery Risk in Women With a History of Gestational Diabetes. Obstet Gynecol. 2009;113(4):817-23. PubMed PMID: 19305325.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interpregnancy weight gain and cesarean delivery risk in women with a history of gestational diabetes. AU - Paramsothy,Pathmaja, AU - Lin,Yvonne S, AU - Kernic,Mary A, AU - Foster-Schubert,Karen E, PY - 2009/3/24/entrez PY - 2009/3/24/pubmed PY - 2009/5/20/medline SP - 817 EP - 23 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 113 IS - 4 N2 - OBJECTIVE: Along with the rising prevalence of obesity, rates of gestational diabetes mellitus (GDM) and associated adverse outcomes also have increased. We conducted a population-based, retrospective cohort study to assess the association of weight gain between pregnancies with cesarean delivery for the subsequent pregnancy among women with a history of GDM. METHODS: Using linked birth-certificate data for women with at least two singleton births in Washington State during the period from 1992-2005, we identified 2,753 women with GDM who delivered vaginally at the baseline pregnancy (first pregnancy on record). The interpregnancy weight change (subsequent-baseline prepregnancy weight) for each woman was calculated and assigned to one of three categories: weight loss (more than 10 lb), weight stable (+/-10 lb), or weight gain (more than 10 lb). Multiple logistic regression was used to calculate the risk (odds ratio [OR]) of cesarean delivery at the subsequent pregnancy among the weight-gain and weight-loss groups relative to the weight-stable category. RESULTS: Among 2,581 eligible women, 10.9% lost more than 10 lb between pregnancies, 54.0% were weight-stable, and 35.1% gained more than 10 lb. Women who gained more than 10 lb had an adjusted OR for subsequent cesarean delivery of 1.70 (95% confidence interval [CI] 1.16-2.49, 9.7% of women who gained weight), whereas the adjusted OR for women who lost weight was 0.55 (95% CI 0.28-1.10, 4.7% of women who lost weight). CONCLUSION: Women with a history of GDM who gained more than 10 lb between pregnancies are at increased risk of future cesarean delivery. Appropriate weight management among women with a history of GDM may result in decreased cesarean delivery rates along with decreases in associated excess risks and costs. LEVEL OF EVIDENCE: II. SN - 0029-7844 UR - https://www.unboundmedicine.com/medline/citation/19305325/Interpregnancy_weight_gain_and_cesarean_delivery_risk_in_women_with_a_history_of_gestational_diabetes_ L2 - http://dx.doi.org/10.1097/AOG.0b013e31819b33ac DB - PRIME DP - Unbound Medicine ER -