title: Maternal weight gain in women who develop gestational diabetes mellitus.
abstract: OBJECTIVE
  To assess maternal weight gain before 24 weeks in women developing gestational diabetes mellitus (GDM) compared with controls with normal glucose tolerance.
  
  
  METHODS
  This was a retrospective cohort study of maternal weight gain. Women developing GDM were matched to three controls by self-reported prepregnancy body mass index (BMI), maternal age, race, and parity. Women without documented pregravid or 22- to 24-week weights and multiple gestations were excluded. The primary outcome was weight gain through 24 weeks of gestation.
  
  
  RESULTS
  Six hundred fifty-two women (163 in the GDM group and 489 controls) underwent chart review. There were no significant differences in race (36% compared with 36% African American, P=.99), age (28.7 ± 6.3 years compared with 29.4 ± 6.9 years, P=.26) or prepregnancy BMI (31.7 ± 8.2 compared with 31.8 ± 8.6, P=.88). Maternal weight gain was higher in the GDM group than in the control group (14.8 compared with 11.2 lb, P<.001). When controlling for prepregnancy BMI, overweight (18.6 compared with 12.9 lb, P<.004), and obese (12.6 compared with 8.8 lb, P<.008), GDM participants gained significantly more weight by 24 weeks. Both diet-controlled (A1) and insulin-requiring (A2) GDM had higher weight gain compared with controls (control compared with A1: 11.2 compared with 15.3 lb, P=.029; control compared with A2: 11.2 compared with 14.6 lb, P=.018. No difference was found between A1 and A2 patients (P=.942).
  
  
  CONCLUSIONS
  Women who develop GDM have higher gestational weight gain through 24 weeks. Gestational weight gain is a significant risk factor for GDM in the overweight or obese patient but not in patients who were underweight or had a normal BMI before pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio 44109, USA. kgibson@metrohealth.org
authors.forename: Kelly S
authors.initials: KS
authors.lastname: Gibson
authors.forename: Thaddeus P
authors.initials: TP
authors.lastname: Waters
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Catalano
mesh_terms: D000293:Adolescent; D000328:Adult; D044383:Black People / Q000706:statistics & numerical data; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000178:diet therapy / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D012307:Risk Factors; D015430:Weight Gain / Q000502:physiology*; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult; D001741:Black or African American
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin