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The institute of medicine guidelines for gestational weight gain after a diagnosis of gestational diabetes and pregnancy outcomes.
Am J Perinatol. 2015 Feb; 32(3):239-46.AJ

Abstract

OBJECTIVE

The objective of this study was to assess the impact of gestational weight gain outside the Institute of Medicine (IOM) recommendations after the diagnosis of gestational diabetes (GDM) on perinatal outcomes.

MATERIALS AND METHODS

This was a retrospective cohort study. Women were classified as gestational weight gain (GWG) within, less than, or greater than IOM recommendations for body mass index as calculated by gestational weight gain per week after a diagnosis of GDM. Outcomes assessed were preeclampsia, cesarean delivery, A2 GDM, birth weight, small for gestational age (SGA), large for gestational age (LGA), macrosomia, and preterm delivery. Groups were compared using analysis of variance and chi-square test for trend, as appropriate. Backward stepwise logistic regression was used to adjust for significant confounding factors.

RESULTS

Of 635 subjects, 92 gained within, 175 gained less than, and 368 gained more than IOM recommendations. The risk of cesarean delivery and A2 GDM was increased in those gaining above the IOM recommendations compared with within. For every 1-lb/week increase in weight gain after diagnosis of GDM, there was a 36 to 83% increase in the risk of preeclampsia, cesarean delivery, A2 GDM, macrosomia, and LGA, without decreases in SGA or preterm delivery.

CONCLUSION

Weight gain more than the IOM recommendations per week of gestation after a diagnosis of GDM is associated with adverse pregnancy outcomes.

Authors+Show Affiliations

The Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.The Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.The Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.

Pub Type(s)

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

Language

eng

PubMed ID

24971568

Citation

Harper, Lorie M., et al. "The Institute of Medicine Guidelines for Gestational Weight Gain After a Diagnosis of Gestational Diabetes and Pregnancy Outcomes." American Journal of Perinatology, vol. 32, no. 3, 2015, pp. 239-46.
Harper LM, Tita A, Biggio JR. The institute of medicine guidelines for gestational weight gain after a diagnosis of gestational diabetes and pregnancy outcomes. Am J Perinatol. 2015;32(3):239-46.
Harper, L. M., Tita, A., & Biggio, J. R. (2015). The institute of medicine guidelines for gestational weight gain after a diagnosis of gestational diabetes and pregnancy outcomes. American Journal of Perinatology, 32(3), 239-46. https://doi.org/10.1055/s-0034-1383846
Harper LM, Tita A, Biggio JR. The Institute of Medicine Guidelines for Gestational Weight Gain After a Diagnosis of Gestational Diabetes and Pregnancy Outcomes. Am J Perinatol. 2015;32(3):239-46. PubMed PMID: 24971568.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The institute of medicine guidelines for gestational weight gain after a diagnosis of gestational diabetes and pregnancy outcomes. AU - Harper,Lorie M, AU - Tita,Alan, AU - Biggio,Joseph R, Y1 - 2014/06/27/ PY - 2014/6/28/entrez PY - 2014/6/28/pubmed PY - 2015/12/15/medline SP - 239 EP - 46 JF - American journal of perinatology JO - Am J Perinatol VL - 32 IS - 3 N2 - OBJECTIVE: The objective of this study was to assess the impact of gestational weight gain outside the Institute of Medicine (IOM) recommendations after the diagnosis of gestational diabetes (GDM) on perinatal outcomes. MATERIALS AND METHODS: This was a retrospective cohort study. Women were classified as gestational weight gain (GWG) within, less than, or greater than IOM recommendations for body mass index as calculated by gestational weight gain per week after a diagnosis of GDM. Outcomes assessed were preeclampsia, cesarean delivery, A2 GDM, birth weight, small for gestational age (SGA), large for gestational age (LGA), macrosomia, and preterm delivery. Groups were compared using analysis of variance and chi-square test for trend, as appropriate. Backward stepwise logistic regression was used to adjust for significant confounding factors. RESULTS: Of 635 subjects, 92 gained within, 175 gained less than, and 368 gained more than IOM recommendations. The risk of cesarean delivery and A2 GDM was increased in those gaining above the IOM recommendations compared with within. For every 1-lb/week increase in weight gain after diagnosis of GDM, there was a 36 to 83% increase in the risk of preeclampsia, cesarean delivery, A2 GDM, macrosomia, and LGA, without decreases in SGA or preterm delivery. CONCLUSION: Weight gain more than the IOM recommendations per week of gestation after a diagnosis of GDM is associated with adverse pregnancy outcomes. SN - 1098-8785 UR - https://www.unboundmedicine.com/medline/citation/24971568/The_institute_of_medicine_guidelines_for_gestational_weight_gain_after_a_diagnosis_of_gestational_diabetes_and_pregnancy_outcomes_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0034-1383846 DB - PRIME DP - Unbound Medicine ER -