Pregestational body mass index, weight gain during pregnancy and maternal hyperglycemia.
OBJECTIVE
To evaluate the associations between pregestational BMI and weight gain during pregnancy and the risk for maternal hyperglycemia.


METHODS
The charts of all patients who delivered at our hospital between June 2001 and June 2006 were reviewed. Maternal hyperglycemia categories were defined as GDM (by the Carpenter and Coustan criteria); Impaired glucose tolerance (IGT - only one abnormal value in the 100 g OGTT); Abnormal GCT (≥140 mg/dL) but no high values on the OGTT. Women with GCT < 140 were defined as normal glucose tolerance (NGT).


RESULTS
Pregravid BMI and glucose tolerance data were available for 9269 women. We also had data on weight gain during pregnancy for 7766 of these women. There was strong graded association between increasing BMI category and all levels of maternal hyperglycemia. There was significant negative correlation between BMI and weight gain during pregnancy (R = -0.251, P value < 0.0001). However, in the multivariate logistic regression model, only pregestational BMI was significantly associated with maternal hyperglycemia, whereas weight gain during pregnancy was no longer significant.


CONCLUSIONS
Obesity is a strong predictor for gestational maternal hyperglycemia. Weight gain during pregnancy has less effect. Every effort should be made for pregestational weight reduction in overweight women.
Riskin-Mashiah
Shlomit
S
Rappaport Faculty of Medicine, Departement of Obstetrics and Gynecology, The Lady Davis Carmel Medical Center, Technion, Haifa, Israel. shlomitriskin@gmail.com
Damti
Amit
A
Younes
Grace
G
Auslander
Ron
R
D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D018149:Glucose Intolerance / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D006943:Hyperglycemia / Q000378:metabolism / Q000503:physiopathology*; D009765:Obesity / Q000378:metabolism / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000378:metabolism / Q000503:physiopathology*; D015430:Weight Gain / Q000502:physiology*
D001786:Blood Glucose