Weight gain, total fat gain and regional fat gain during pregnancy and the association with gestational diabetes: a population-based cohort study.
OBJECTIVE
In a multi-ethnic population-based study, we investigate the change in indicators of adiposity (being weight gain and gain of total fat, truncal fat and mean skinfold thickness) from early pregnancy to 28 weeks of gestation overall and across ethnic groups, and explore the association between the change in indicators of adiposity and gestational diabetes (GDM).


METHODS
Weight, skinfold thickness and bioelectrical impedance analysis were performed twice in 728 pregnant women in gestational week 15 (visit 1) and week 28 (visit 2). GDM was defined by the modified International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria (1-hour glucose not available).


RESULTS
An increase in all indicators of adiposity gave increased odds ratios (OR) for GDM. After adjusting for pre-pregnant body mass index, a 0.14 kg per week (one standard deviation (s.d.)) increase in truncal fat gave an OR of 1.31 (95% CI 1.10-1.56), while a 0.21 kg per week (one s.d.) weight gain gave an OR of 1.23 (95% CI 1.04-1.46) for GDM. The ORs for the indicators of adiposity remained after additional adjustments for insulin resistance in early pregnancy. When combining the effects of an ethnic origin, 0.14 kg per week (one s.d.) truncal fat gain and 4.7 kg m(-2) (one s.d.) increased pre-pregnant BMI the OR for South Asians was 5.9 (3.5-10.0) versus 2.1 (1.6-2.8) for Europeans.


CONCLUSIONS
Weight gain and gain of total fat mass, mean skinfold thickness and especially truncal fat were all positively associated with GDM. South Asians, in particular, should be encouraged to avoid an excessive weight gain during pregnancy to reduce risk of GDM.
1] Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway [2] Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
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Sommer
1] Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway [2] Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
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Mørkrid
1] Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway [2] Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
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Jenum
1] Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway [2] Norwegian Resource Centre for Women's Health, Oslo University Hospital, Oslo, Norway.
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Sletner
Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
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Mosdøl
1] Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway [2] Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
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Birkeland
D050154:Adiposity; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D001213:Asian / Q000706:statistics & numerical data; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D005006:Ethnicity; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D011247:Pregnancy; D015995:Prevalence; D012885:Skinfold Thickness; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D015430:Weight Gain; D044465:White People / Q000706:statistics & numerical data