Disclosure: None of the authors have a conflict of interest.
Gestational weight loss and perinatal outcomes in overweight and obese women subsequent to diagnosis of gestational diabetes mellitus
Version of Record online: 5 JUL 2013
Copyright © 2013 The Obesity Society
Volume 21, Issue 12, pages E770–E774, December 2013
How to Cite
Yee, L. M., Cheng, Y. W., Inturrisi, M. and Caughey, A. B. (2013), Gestational weight loss and perinatal outcomes in overweight and obese women subsequent to diagnosis of gestational diabetes mellitus. Obesity, 21: E770–E774. doi: 10.1002/oby.20490
Funding agencies: Dr. Yvonne Cheng is supported by the UCSF Women's Reproductive Health Research Career Development Award, NIH, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12 HD001262).
Author contributions: LY contributed to the conception and design of the study, literature search, acquisition of data, data analysis and interpretation, and drafting and critical revision of the manuscript. YC contributed to the conception and design of the study, data acquisition and analysis, data interpretation, and writing of the manuscript. MI contributed to the design of the study and data acquisition. AC contributed to the conception and design of the study, data analysis, and interpretation of data. All authors were involved in drafting and critical revision of the manuscript and had final approval of the submitted version.
- Issue online: 3 DEC 2013
- Version of Record online: 5 JUL 2013
- Accepted manuscript online: 24 APR 2013 03:23AM EST
- Manuscript Accepted: 25 MAR 2013
- Manuscript Received: 1 NOV 2012
To investigate whether gestational weight loss (GWL) after the diagnosis of gestational diabetes mellitus (GDM) in overweight and obese women is associated with improved perinatal outcomes. Obesity and GDM are risk factors for adverse perinatal outcomes, but few studies have investigated weight loss during pregnancy in women with these comorbidities.
Design and Methods
Retrospective cohort study of 26,205 overweight and obese gestational diabetic women enrolled in the California Diabetes and Pregnancy Program. Women with GWL during program enrollment were compared to those with weight gain. Perinatal outcomes were assessed using chi-square test and multivariable logistic regression analysis.
About 5.2% of women experienced GWL. GWL was associated with decreased odds of macrosomia (aOR 0.63, 95% CI 0.52-0.77), NICU admission (aOR 0.51, 95% CI 0.27-0.95), and cesarean delivery (aOR 0.81, 95% CI 0.68-0.97). Odds of SGA status (aOR 1.69, 95% CI 1.32-2.17) and preterm delivery <34 weeks (aOR 1.71, 95% CI 1.23-2.37) were increased.
In overweight and obese women with GDM, third trimester weight loss is associated with some improved maternal and neonatal outcomes, although this effect is lessened by increased odds of SGA status and preterm delivery. Further research on weight loss and interventions to improve adherence to weight guidelines in this population is recommended.