title: Excessive early gestational weight gain and risk of gestational diabetes mellitus in nulliparous women.
abstract: OBJECTIVE
  To estimate whether there is an association between excessive early gestational weight gain and the development of gestational diabetes mellitus (GDM) and excessive fetal growth.
  
  
  METHODS
  This is a secondary analysis of a randomized controlled trial of vitamins C and E in nulliparous low-risk women. Maternal weight gain from prepregnancy (self-reported) to 15-18 weeks of gestation was measured, and expected gestational weight gain was determined using the Institute of Medicine 2009 guidelines for each prepregnancy body mass index category. Excessive early gestational weight gain was defined as gestational weight gain greater than the upper range of the Institute of Medicine guidelines. Rates of GDM, birth weight greater than 4,000 g, and large for gestational age (LGA, birth weight 90 percentile or higher) were calculated and compared between women with excessive early gestational weight gain and early nonexcessive gestational weight gain (within or below Institute of Medicine guidelines).
  
  
  RESULTS
  A total of 7,985 women were studied. Excessive early gestational weight gain occurred in 47.5% of women. Ninety-three percent of women with excessive early gestational weight gain had total gestational weight gain greater than Institute of Medicine guidelines. In contrast, only 55% of women with nonexcessive early gestational weight gain had total gestational weight gain greater than Institute of Medicine guidelines (P<.001). Rates of GDM, LGA, and birth weight greater than 4,000 g were higher in women with excessive early gestational weight gain.
  
  
  CONCLUSIONS
  In our population, excessive early gestational weight gain occurred in 93% of women who had total gestational weight gain greater than the Institute of Medicine guidelines. In low-risk nulliparous women, excessive early gestational weight gain is associated with the development of GDM and excessive fetal growth.
  
  
  METHODS
  II.
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Health Science Center, Houston, TX, USA.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Carreno
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Clifton
authors.forename: John C
authors.initials: JC
authors.lastname: Hauth
authors.forename: Leslie
authors.initials: L
authors.lastname: Myatt
authors.forename: James M
authors.initials: JM
authors.lastname: Roberts
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Spong
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: John M
authors.initials: JM
authors.lastname: Thorp
authors.forename: Brian M
authors.initials: BM
authors.lastname: Mercer
authors.forename: Alan M
authors.initials: AM
authors.lastname: Peaceman
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ramin
authors.forename: Marshall W
authors.initials: MW
authors.lastname: Carpenter
authors.forename: Anthony
authors.initials: A
authors.lastname: Sciscione
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Tolosa
authors.forename: George R
authors.initials: GR
authors.lastname: Saade
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D047109:Fetal Development; D006801:Humans; D010298:Parity; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D015430:Weight Gain; D055815:Young Adult