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Published in: Diabetology & Metabolic Syndrome 1/2024

Open Access 01-12-2024 | Obesity | Research

The association between gestational weight trajectories in women with gestational diabetes and their offspring's weight from birth to 40 months

Authors: Wei Zheng, Jia Wang, Yichen Li, Xiaorui Shang, Kaiwen Ma, Xianxian Yuan, Kexin Zhang, Ruihua Yang, Yuru Ma, Guanghui Li

Published in: Diabetology & Metabolic Syndrome | Issue 1/2024

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Abstract

Aims

To identify the gestational weight gain (GWG) patterns in women with gestational diabetes mellitus (GDM) and evaluate their association with offspring weight status from birth to 40 months.

Materials and methods

This study included 2,723 GDM-mother–child pairs from the Beijing Birth Cohort Study. The association between GWG trajectories identified by the latent class model and offspring weight outcomes from birth to 40 months were evaluated, after adjustment for maternal age, parity, pre-pregnancy body mass index, maternal height, and blood glucose levels.

Results

Three GWG rate groups, including the non-excessive GWG group (1,994/2,732), excessive GWG group (598 /2,732), and excessive early GWG group (140/2,732), were identified in women with GDM, respectively. Compared to the non-excessive GWG group, the adjusted OR (aOR) and 95% CI were 1.83 (1.35–2.47) and 1.79 (1.06–3.01) for macrosomia, 1.33 (1.07–1.66) and 1.48 (1.01–2.17) for large for gestational age (LGA) in the excessive GWG group and excessive early GWG group. Excessive GWG was also associated with an increased risk of BMI-for-age at 40 months (aOR = 1.66, 95% CI 1.14–2.42).

Conclusions

Both excessive GWG and excessive early GWG increased the risk of macrosomia and LGA in women with GDM, but only the excessive GWG was associated with childhood overweight/obesity. The results suggest the long-term impact of GWG on offspring weight status in women with GDM and the potential benefits of GWG restriction after GDM diagnosis.
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Literature
1.
go back to reference Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, Malanda B. IDF Diabetes Atlas: global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018;138:271–81.CrossRefPubMed Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, Malanda B. IDF Diabetes Atlas: global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018;138:271–81.CrossRefPubMed
2.
go back to reference Ye W, Luo C, Huang J, Li C, Liu Z, Liu F. Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis. BMJ. 2022;377:e067946.CrossRefPubMedPubMedCentral Ye W, Luo C, Huang J, Li C, Liu Z, Liu F. Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis. BMJ. 2022;377:e067946.CrossRefPubMedPubMedCentral
3.
go back to reference Kc K, Shakya S, Zhang H. Gestational diabetes mellitus and macrosomia: a literature review. Ann Nutr Metab. 2015;66(Suppl 2):14–20.CrossRefPubMed Kc K, Shakya S, Zhang H. Gestational diabetes mellitus and macrosomia: a literature review. Ann Nutr Metab. 2015;66(Suppl 2):14–20.CrossRefPubMed
4.
go back to reference Gao M, Cao S, Li N, Liu J, Lyu Y, Li J, Yang X. Risks of overweight in the offspring of women with gestational diabetes at different developmental stages: a meta-analysis with more than half a million offspring. Obes Rev. 2022;23(3):e13395.CrossRefPubMed Gao M, Cao S, Li N, Liu J, Lyu Y, Li J, Yang X. Risks of overweight in the offspring of women with gestational diabetes at different developmental stages: a meta-analysis with more than half a million offspring. Obes Rev. 2022;23(3):e13395.CrossRefPubMed
5.
go back to reference Lowe WL Jr, Scholtens DM, Lowe LP, Kuang A, Nodzenski M, Talbot O, Catalano PM, Linder B, Brickman WJ, Clayton P, et al. Association of gestational diabetes with maternal disorders of glucose metabolism and childhood adiposity. JAMA. 2018;320(10):1005–16.CrossRefPubMedPubMedCentral Lowe WL Jr, Scholtens DM, Lowe LP, Kuang A, Nodzenski M, Talbot O, Catalano PM, Linder B, Brickman WJ, Clayton P, et al. Association of gestational diabetes with maternal disorders of glucose metabolism and childhood adiposity. JAMA. 2018;320(10):1005–16.CrossRefPubMedPubMedCentral
6.
go back to reference Kim SY, England JL, Sharma JA, Njoroge T. Gestational diabetes mellitus and risk of childhood overweight and obesity in offspring: a systematic review. Exp Diabetes Res. 2011;2011:541308.CrossRefPubMedPubMedCentral Kim SY, England JL, Sharma JA, Njoroge T. Gestational diabetes mellitus and risk of childhood overweight and obesity in offspring: a systematic review. Exp Diabetes Res. 2011;2011:541308.CrossRefPubMedPubMedCentral
7.
go back to reference Zhao P, Liu E, Qiao Y, Katzmarzyk PT, Chaput JP, Fogelholm M, Johnson WD, Kuriyan R, Kurpad A, Lambert EV, et al. Maternal gestational diabetes and childhood obesity at age 9–11: results of a multinational study. Diabetologia. 2016;59(11):2339–48.CrossRefPubMedPubMedCentral Zhao P, Liu E, Qiao Y, Katzmarzyk PT, Chaput JP, Fogelholm M, Johnson WD, Kuriyan R, Kurpad A, Lambert EV, et al. Maternal gestational diabetes and childhood obesity at age 9–11: results of a multinational study. Diabetologia. 2016;59(11):2339–48.CrossRefPubMedPubMedCentral
8.
go back to reference Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, Li N, Hu G, Corrado F, Rode L, et al. Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis. JAMA. 2017;317(21):2207–25.CrossRefPubMedPubMedCentral Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, Li N, Hu G, Corrado F, Rode L, et al. Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis. JAMA. 2017;317(21):2207–25.CrossRefPubMedPubMedCentral
9.
go back to reference Liu Y, Dai W, Dai X, Li Z. Prepregnancy body mass index and gestational weight gain with the outcome of pregnancy: a 13-year study of 292,568 cases in China. Arch Gynecol Obstet. 2012;286(4):905–11.CrossRefPubMed Liu Y, Dai W, Dai X, Li Z. Prepregnancy body mass index and gestational weight gain with the outcome of pregnancy: a 13-year study of 292,568 cases in China. Arch Gynecol Obstet. 2012;286(4):905–11.CrossRefPubMed
10.
go back to reference Kim SY, Sharma AJ, Sappenfield W, Wilson HG, Salihu HM. Association of maternal body mass index, excessive weight gain, and gestational diabetes mellitus with large-for-gestational-age births. Obstet Gynecol. 2014;123(4):737–44.CrossRefPubMedPubMedCentral Kim SY, Sharma AJ, Sappenfield W, Wilson HG, Salihu HM. Association of maternal body mass index, excessive weight gain, and gestational diabetes mellitus with large-for-gestational-age births. Obstet Gynecol. 2014;123(4):737–44.CrossRefPubMedPubMedCentral
11.
go back to reference Voerman E, Santos S, Patro Golab B, Amiano P, Ballester F, Barros H, Bergström A, Charles M-A, Chatzi L, Chevrier C, et al. Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: an individual participant data meta-analysis. PLoS Med. 2019;16(2):e1002744.CrossRefPubMedPubMedCentral Voerman E, Santos S, Patro Golab B, Amiano P, Ballester F, Barros H, Bergström A, Charles M-A, Chatzi L, Chevrier C, et al. Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: an individual participant data meta-analysis. PLoS Med. 2019;16(2):e1002744.CrossRefPubMedPubMedCentral
12.
go back to reference Viecceli C, Remonti LR, Hirakata VN, Mastella LS, Gnielka V, Oppermann ML, Silveiro SP, Reichelt AJ. Weight gain adequacy and pregnancy outcomes in gestational diabetes: a meta-analysis. Obes Rev. 2017;18(5):567–80.CrossRefPubMed Viecceli C, Remonti LR, Hirakata VN, Mastella LS, Gnielka V, Oppermann ML, Silveiro SP, Reichelt AJ. Weight gain adequacy and pregnancy outcomes in gestational diabetes: a meta-analysis. Obes Rev. 2017;18(5):567–80.CrossRefPubMed
13.
go back to reference Zheng W, Huang W, Liu C, Yan Q, Zhang L, Tian Z, Yuan X, Li G. Weight gain after diagnosis of gestational diabetes mellitus and its association with adverse pregnancy outcomes: a cohort study. BMC Pregnancy Childbirth. 2021;21(1):216.CrossRefPubMedPubMedCentral Zheng W, Huang W, Liu C, Yan Q, Zhang L, Tian Z, Yuan X, Li G. Weight gain after diagnosis of gestational diabetes mellitus and its association with adverse pregnancy outcomes: a cohort study. BMC Pregnancy Childbirth. 2021;21(1):216.CrossRefPubMedPubMedCentral
14.
go back to reference Mustaniemi S, Nikkinen H, Bloigu A, Pouta A, Kaaja R, Eriksson JG, Laivuori H, Gissler M, Kajantie E, Vääräsmäki M. Normal gestational weight gain protects from large-for-gestational-age birth among women with obesity and gestational diabetes. Front Public Health. 2021;9:550860.CrossRefPubMedPubMedCentral Mustaniemi S, Nikkinen H, Bloigu A, Pouta A, Kaaja R, Eriksson JG, Laivuori H, Gissler M, Kajantie E, Vääräsmäki M. Normal gestational weight gain protects from large-for-gestational-age birth among women with obesity and gestational diabetes. Front Public Health. 2021;9:550860.CrossRefPubMedPubMedCentral
15.
go back to reference Gaillard R, Steegers EA, Franco OH, Hofman A, Jaddoe VW. Maternal weight gain in different periods of pregnancy and childhood cardio-metabolic outcomes. The generation R study. Int J Obes. 2014;39(4):677.CrossRef Gaillard R, Steegers EA, Franco OH, Hofman A, Jaddoe VW. Maternal weight gain in different periods of pregnancy and childhood cardio-metabolic outcomes. The generation R study. Int J Obes. 2014;39(4):677.CrossRef
16.
go back to reference Bayer O, Ensenauer R, Nehring I, Kries RV. Effects of trimester-specific and total gestational weight gain on children’s anthropometrics. BMC Pregnancy Childbirth. 2014;14(1):1–7.CrossRef Bayer O, Ensenauer R, Nehring I, Kries RV. Effects of trimester-specific and total gestational weight gain on children’s anthropometrics. BMC Pregnancy Childbirth. 2014;14(1):1–7.CrossRef
17.
go back to reference Department of Disease Control MoH, PRC: Guidelines for the prevention and control of overweight and obesity in Chinese adults: People's Medical Publishing House; 2006. Department of Disease Control MoH, PRC: Guidelines for the prevention and control of overweight and obesity in Chinese adults: People's Medical Publishing House; 2006.
18.
go back to reference Association OGoOaGSotCMACGoPwdoPMSotCM: Guidelines for the Management of Gestational Diabetes mellitus (2014). Diabetes World. 2014; 8(11):489–498. Association OGoOaGSotCMACGoPwdoPMSotCM: Guidelines for the Management of Gestational Diabetes mellitus (2014). Diabetes World. 2014; 8(11):489–498.
19.
go back to reference Villar J, Cheikh Ismail L, Victora CG, Ohuma EO, Bertino E, Altman DG, Lambert A, Papageorghiou AT, Carvalho M, Jaffer YA, et al. International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet. 2014;384(9946):857–68.CrossRefPubMed Villar J, Cheikh Ismail L, Victora CG, Ohuma EO, Bertino E, Altman DG, Lambert A, Papageorghiou AT, Carvalho M, Jaffer YA, et al. International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet. 2014;384(9946):857–68.CrossRefPubMed
21.
go back to reference Nana L, Jinlang L, Haijun W, Yin S, Suhan Z, Hang L, Yaxin W, Xuanjin Y, Shuai M, Na H, et al. Weekly weight gain in women with gestational diabetes mellitus and neonatal birth weight — China, 2011–2021. China CDC Weekly. 2023;5(32):703–9.CrossRef Nana L, Jinlang L, Haijun W, Yin S, Suhan Z, Hang L, Yaxin W, Xuanjin Y, Shuai M, Na H, et al. Weekly weight gain in women with gestational diabetes mellitus and neonatal birth weight — China, 2011–2021. China CDC Weekly. 2023;5(32):703–9.CrossRef
22.
go back to reference Santos Monteiro S, Santos TS, Fonseca L, Saraiva M, Pichel F, Pinto C, Pereira MT, Vilaverde J, Almeida MC, Dores J. Inappropriate gestational weight gain impact on maternofetal outcomes in gestational diabetes. Ann Med. 2023;55(1):207–14.CrossRefPubMed Santos Monteiro S, Santos TS, Fonseca L, Saraiva M, Pichel F, Pinto C, Pereira MT, Vilaverde J, Almeida MC, Dores J. Inappropriate gestational weight gain impact on maternofetal outcomes in gestational diabetes. Ann Med. 2023;55(1):207–14.CrossRefPubMed
23.
go back to reference Pugh SJ, Albert PS, Kim S, Grobman W, Hinkle SN, Newman RB, Wing DA, Grantz KL. Patterns of gestational weight gain and birthweight outcomes in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singletons: a prospective study. Am J Obstet Gynecol. 2017;217(3):346.e341.CrossRef Pugh SJ, Albert PS, Kim S, Grobman W, Hinkle SN, Newman RB, Wing DA, Grantz KL. Patterns of gestational weight gain and birthweight outcomes in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singletons: a prospective study. Am J Obstet Gynecol. 2017;217(3):346.e341.CrossRef
24.
go back to reference Zheng W, Huang W, Zhang Z, Zhang L, Tian Z, Li G, Zhang W. Patterns of gestational weight gain in women with overweight or obesity and risk of large for gestational age. Obes Facts. 2019;12(4):407–15.CrossRefPubMedPubMedCentral Zheng W, Huang W, Zhang Z, Zhang L, Tian Z, Li G, Zhang W. Patterns of gestational weight gain in women with overweight or obesity and risk of large for gestational age. Obes Facts. 2019;12(4):407–15.CrossRefPubMedPubMedCentral
25.
go back to reference Xu H, Wu L, Lu H, Sun Y, Wu D, He Y, Yu L, Peng H, Li H. Relationship between gestational weight gain rate trajectory and overweight in offspring at three years of age. Childhood obesity (Print). 2022;18(8):540–7.CrossRefPubMed Xu H, Wu L, Lu H, Sun Y, Wu D, He Y, Yu L, Peng H, Li H. Relationship between gestational weight gain rate trajectory and overweight in offspring at three years of age. Childhood obesity (Print). 2022;18(8):540–7.CrossRefPubMed
26.
go back to reference Hod M, Kapur A, Sacks DA, Hadar E, Agarwal M, Di Renzo GC, Cabero Roura L, McIntyre HD, Morris JL, Divakar H. The International Federation of Gynecology and Obstetrics (FIGO) Initiative on gestational diabetes mellitus: a pragmatic guide for diagnosis, management, and care. Int J Gynaecol Obstetr. 2015;131(Suppl 3):S173-211.CrossRef Hod M, Kapur A, Sacks DA, Hadar E, Agarwal M, Di Renzo GC, Cabero Roura L, McIntyre HD, Morris JL, Divakar H. The International Federation of Gynecology and Obstetrics (FIGO) Initiative on gestational diabetes mellitus: a pragmatic guide for diagnosis, management, and care. Int J Gynaecol Obstetr. 2015;131(Suppl 3):S173-211.CrossRef
27.
go back to reference Brunner S, Stecher L, Ziebarth S, Nehring I, Rifas-Shiman SL, Sommer C, Hauner H, von Kries R. Excessive gestational weight gain prior to glucose screening and the risk of gestational diabetes: a meta-analysis. Diabetologia. 2015;58(10):2229–37.CrossRefPubMed Brunner S, Stecher L, Ziebarth S, Nehring I, Rifas-Shiman SL, Sommer C, Hauner H, von Kries R. Excessive gestational weight gain prior to glucose screening and the risk of gestational diabetes: a meta-analysis. Diabetologia. 2015;58(10):2229–37.CrossRefPubMed
28.
go back to reference Barnes RA, Flack JR, Wong T, Ross GP, Griffiths MM, Stephens M, Kourloufas L, Smart CE, Collins CE, MacDonald-Wicks L. Does weight management after gestational diabetes mellitus diagnosis improve pregnancy outcomes? A multi-ethnic cohort study. Diabetic Med. 2022;39(1):e14692.CrossRefPubMed Barnes RA, Flack JR, Wong T, Ross GP, Griffiths MM, Stephens M, Kourloufas L, Smart CE, Collins CE, MacDonald-Wicks L. Does weight management after gestational diabetes mellitus diagnosis improve pregnancy outcomes? A multi-ethnic cohort study. Diabetic Med. 2022;39(1):e14692.CrossRefPubMed
29.
go back to reference Barnes RA, Wong T, Ross GP, Griffiths MM, Smart CE, Collins CE, MacDonald-Wicks L, Flack JR. Excessive weight gain before and during gestational diabetes mellitus management: what is the impact? Diabetes Care. 2020;43(1):74–81.CrossRefPubMed Barnes RA, Wong T, Ross GP, Griffiths MM, Smart CE, Collins CE, MacDonald-Wicks L, Flack JR. Excessive weight gain before and during gestational diabetes mellitus management: what is the impact? Diabetes Care. 2020;43(1):74–81.CrossRefPubMed
30.
go back to reference Group HSCR, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, Hadden DR, McCance DR, Hod M, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358(19):1991–2002.CrossRef Group HSCR, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, Hadden DR, McCance DR, Hod M, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358(19):1991–2002.CrossRef
31.
go back to reference McIntyre HD, Catalano P, Zhang C, Desoye G, Mathiesen ER, Damm P. Gestational diabetes mellitus. Nat Rev Dis Primers. 2019;5(1):47.CrossRefPubMed McIntyre HD, Catalano P, Zhang C, Desoye G, Mathiesen ER, Damm P. Gestational diabetes mellitus. Nat Rev Dis Primers. 2019;5(1):47.CrossRefPubMed
32.
go back to reference Hanson MA, Bardsley A, De-Regil LM, Moore SE, Oken E, Poston L, Ma RC, McAuliffe FM, Maleta K, Purandare CN, et al. The International Federation of Gynecology and Obstetrics (FIGO) recommendations on adolescent, preconception, and maternal nutrition: “Think Nutrition First.” Int J Gynaecol Obstetr. 2015;131(Suppl 4):S213-253.CrossRef Hanson MA, Bardsley A, De-Regil LM, Moore SE, Oken E, Poston L, Ma RC, McAuliffe FM, Maleta K, Purandare CN, et al. The International Federation of Gynecology and Obstetrics (FIGO) recommendations on adolescent, preconception, and maternal nutrition: “Think Nutrition First.” Int J Gynaecol Obstetr. 2015;131(Suppl 4):S213-253.CrossRef
33.
go back to reference Geurtsen ML, Jaddoe VWV, Gaillard R, Felix JF. Associations of maternal early-pregnancy blood glucose and insulin concentrations with DNA methylation in newborns. Clin Epigenet. 2020;12(1):134–134.CrossRef Geurtsen ML, Jaddoe VWV, Gaillard R, Felix JF. Associations of maternal early-pregnancy blood glucose and insulin concentrations with DNA methylation in newborns. Clin Epigenet. 2020;12(1):134–134.CrossRef
Metadata
Title
The association between gestational weight trajectories in women with gestational diabetes and their offspring's weight from birth to 40 months
Authors
Wei Zheng
Jia Wang
Yichen Li
Xiaorui Shang
Kaiwen Ma
Xianxian Yuan
Kexin Zhang
Ruihua Yang
Yuru Ma
Guanghui Li
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Diabetology & Metabolic Syndrome / Issue 1/2024
Electronic ISSN: 1758-5996
DOI
https://doi.org/10.1186/s13098-023-01239-y

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