title: Association between gestational weight gain and postpartum diabetes: evidence from a community based large cohort study.
abstract: We have investigated the prospective association between excess gestational weight gain (GWG) and development of diabetes by 21 years post-partum using a community-based large prospective cohort study in Brisbane, Australia. There were 3386 mothers for whom complete data were available on GWG, pre-pregnancy BMI and self-reported diabetes 21 years post-partum. We used The Institute of Medicine (IOM) definition to categorize GWG as inadequate, adequate and excessive. We found 839 (25.78%) mothers gained inadequate weight, 1,353 (39.96%) had adequate weight gain and 1,194 (35.26%) had gained excessive weight during pregnancy. At 21 years post-partum, 8.40% of mothers self-reported a diagnosis of diabetes made by their doctor. In the age adjusted model, we found mothers who gained excess weight during pregnancy were 1.47 (1.11,1.94) times more likely to experience diabetes at 21 years post-partum compared to the mothers who gained adequate weight. This association was not explained by the potential confounders including maternal age, parity, education, race, smoking, TV watching and exercise. However, this association was mediated by the current BMI. There was no association for the women who had normal BMI before pregnancy and gained excess weight during pregnancy. The findings of this study suggest that women who gain excess weight during pregnancy are at greater risk of being diagnosed with diabetes in later life. This relationship is likely mediated through the pathway of post-partum weight-retention and obesity. This study adds evidence to the argument that excessive GWG during pregnancy for overweight mothers has long term maternal health implications.
authors.affiliation: School of Population Health, The University of Queensland, Brisbane, Australia.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al Mamun
authors.affiliation: School of Population Health, The University of Queensland, Brisbane, Australia.
authors.forename: Munim
authors.initials: M
authors.lastname: Mannan
authors.affiliation: School of Medicine, The University of Queensland, Brisbane, Australia ; Royal Brisbane and Women's Hospital, Brisbane, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: O'Callaghan
authors.affiliation: School of Population Health, The University of Queensland, Brisbane, Australia.
authors.forename: Gail M
authors.initials: GM
authors.lastname: Williams
authors.affiliation: School of Population Health, The University of Queensland, Brisbane, Australia.
authors.forename: Jake M
authors.initials: JM
authors.lastname: Najman
authors.affiliation: Royal Brisbane and Women's Hospital, Brisbane, Australia ; Mater Children's Hospital, and The University of Queensland, Brisbane, Australia.
authors.forename: Leonie K
authors.initials: LK
authors.lastname: Callaway
mesh_terms: D000293:Adolescent; D000328:Adult; D001835:Body Weight / Q000502:physiology*; D005260:Female; D006801:Humans; D016017:Odds Ratio; D049590:Postpartum Period / Q000502:physiology*; D011247:Pregnancy; D011446:Prospective Studies; D015430:Weight Gain / Q000502:physiology*; D055815:Young Adult