Correlation between Gestational Weight Gain and Risk of Gestational Diabetes Mellitus-A Prospective Study at Tertiary Care Hospital from North India

Aim of present study was to estimate the relationship between the rate of gestational weight gain and subsequent risk of Gestatioal Diabetes Mellitus (GDM) We conducted a case?control study in 690 women with GDM and 1600 women in the control group within a unicenter cohort of women delivering between 2008 and 2017 at UP University of medical scirnces, India; who were screened for GDM at 24?28 weeks of gestation. GDM was diagnosed according to the National Diabetes Data Group plasma glucose cut-offs for the 100-g, 3-hour oral glucose tolerance test. Women?s plasma glucose levels, weights and covariate data were obtained by medical record data base. After adjusting for age at delivery, race/ethnicity, parity and prepregnancy body mass index, the risk of GDM increased with increasing rates of gestational weight gain. Compared with the lowest tertile of rate of gestational weight gain (less than 0.27 kg/week), a rate of weight gain from 0.27?0.40 kg/wk and 0.41 kg/wk or more, were associated with increased risks of GDM (odds ratio 1.43, 95% confidence interval 0.96?2.14; and odds ratio 1.74, 95% confidence interval 1.16?2.60, respectively. Weight gain during pregnancy consists of 30% maternal fat accretion with the second half of a normal pregnancy characterized by progressive insulin resistance. The composition of weight gain also varies by trimester: maternal weight gain early in pregnancy is disproportionately fat and could influence subsequent maternal insulin resistance. Surprisingly, few studies have examined the association between gestational weight gain and the risk of GDM. The association must be examined before the diagnosis of GDM to prevent confounding by treatment for GDM. To date, only very few studies, with small numbers of women, have examined gestational weight gain from before pregnancy to the glucose screening test for GDM and the risk of abnormal glucose metabolism with conflicting results. To address this question, we conducted a case-control study to examine the occurrence of GDM in relation to the rate of gestational weight gain (in kilograms per week) assessed before the 50-g, 1-hour glucose challenge screening test (referred to as the glucose screening test hereafter) for GDM. Gestational weight gain during early pregnancy may represent a modifiable risk factor for GDM and needs more attention from health care providers.