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  • Title: Gestational diabetes: maternal weight gain in relation to fetal growth, treatment modality, BMI and glycemic control.
    Author: Most O, Langer O.
    Journal: J Matern Fetal Neonatal Med; 2012 Nov; 25(11):2458-63. PubMed ID: 22185433.
    Abstract:
    OBJECTIVES: We sought to determine the impact of maternal weight gain on fetal growth in gestational diabetes (GDM) in relation to treatment modality, body mass index (BMI) and glycemic control. STUDY DESIGN: Two thousand four hundred fifty-four GDMs were evaluated. Obesity was defined as BMI >29; good glycemic control ≤ 100 mg/dl; maternal age < and >30 years; parity ± 1; large for gestational age (LGA) >90th percentile and small for gestational age (SGA) <10th percentile. RESULTS: SGA rates were similar in all groups. Obese/overweight diet-treated women in glycemic control showed a four-fold higher rate of LGA compared to insulin-treated women. A 36-lb weight gain in insulin-treated patients had a six-fold higher risk. In poor glycemic control, LGA rates were higher in all BMI/weight gain categories. Logistic regressions for LGA/SGA revealed that level of glycemia, weight gain, parity, obesity and treatment (for LGA only) were significant. CONCLUSION: Different thresholds used for different maternal BMI categories in addition to the achievement of glycemic control and pharmacological therapy will enhance pregnancy outcome.
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