title: Changes in prepregnancy body mass index between pregnancies and risk of gestational and type 2 diabetes.
abstract: BACKGROUND
  We investigated whether changes in interpregnancy body mass index (BMI) influence the risk of gestational and type 2 diabetes among a cohort of women with two consecutive live, singleton births of 20-44 weeks gestation (n = 232,272).
  
  
  METHODS
  Logistic regression models were used to examine the risk for development of gestational or type 2 diabetes during the second pregnancy. Mothers with normal weight for both pregnancies (normal-normal) served as the referent group.
  
  
  RESULTS
  Across all BMI categories, mothers with significant weight gain (i.e., moving from a lower BMI category into a higher category) had an increased risk for the development of diabetes. Mothers who moved from normal prepregnancy weight (BMI = 18.5-24.9 kg/m²) in the first pregnancy to obese prepregnancy weight (BMI ≥ 30.0 kg/m²) in the second pregnancy showed the greatest increment in risk. These mothers exhibited a threefold risk for developing diabetes (OR = 3.21, 95% CI 2.76-3.73). Mothers who maintained their interpregnancy BMI weight category or who moved to a lower BMI category had reduced risk for gestational and type 2 diabetes. The risk associated with mothers who moved to a lower BMI category was approximately half that of the normal-normal BMI category.
  
  
  CONCLUSIONS
  Interpregnancy weight gain is associated with a dose-response increase in risk of diabetes. Establishing a normal interpregnancy BMI may reduce the risk of diabetes.
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, University of South Florida, Tampa, FL, USA.
authors.forename: Valerie E
authors.initials: VE
authors.lastname: Whiteman
authors.forename: Muktar H
authors.initials: MH
authors.lastname: Aliyu
authors.forename: Euna M
authors.initials: EM
authors.lastname: August
authors.forename: Cheri
authors.initials: C
authors.lastname: McIntosh
authors.forename: Jingyi
authors.initials: J
authors.lastname: Duan
authors.forename: Amina P
authors.initials: AP
authors.lastname: Alio
authors.forename: Hamisu M
authors.initials: HM
authors.lastname: Salihu
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008923:Missouri / Q000453:epidemiology; D009765:Obesity / Q000150:complications*; D011247:Pregnancy; D015430:Weight Gain; D055815:Young Adult