Weight change and the risk of gestational diabetes in obese women.
BACKGROUND
Obesity is an established risk factor for gestational diabetes. It is not known whether this risk might be reduced through weight loss between pregnancies. We sought to determine whether weight loss between pregnancies reduced the risk of gestational diabetes among obese women.


METHODS
We conducted a population-based cohort study of 4102 women with 2 or more singleton live births in Washington State between 1992 and 1998. All subjects were nondiabetic and obese (at least 200 lbs) at their first birth during these years. Weight change was calculated as the difference between prepregnancy weight for the 2 pregnancies. We estimated relative risks of gestational diabetes at the subsequent delivery through stratified analyses and Mantel-Haenszel estimates.


RESULTS
Thirty-two percent of women lost weight between pregnancies, with a mean weight loss of 23 lbs. Women who lost at least 10 lbs between pregnancies had a decreased risk of gestational diabetes relative to women whose weight changed by less than 10 lbs (relative risk = 0.63; 95% confidence interval = 0.38-1.02, adjusted for age and weight gain during each pregnancy). Of the 61% of women who gained weight between pregnancies, the mean weight gain was 22 lbs. Women who gained at least 10 lbs had an increased risk of gestational diabetes (1.47; 1.05-2.04).


CONCLUSIONS
Even moderate changes in prepregnancy weight can apparently affect the risk of gestational diabetes among obese women. This may offer further motivation for interventions aimed at reducing obesity among women of reproductive age.
University of Washington, School of Public Health and Community Medicine, Department of Epidemiology, Seattle, Washington, USA.
Nicole L
NL
Glazer
Audrey F
AF
Hendrickson
Gina D
GD
Schellenbaum
Beth A
BA
Mueller
D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D005260:Female; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D014861:Washington / Q000453:epidemiology; D015431:Weight Loss / Q000502:physiology*