title: Fetal growth in relation to gestational weight gain in women with type 2 diabetes: an observational study.
abstract: OBJECTIVE
  To evaluate fetal growth in relation to gestational weight gain in women with Type 2 diabetes.
  
  
  METHODS
  A retrospective cohort study of 142 consecutive pregnancies in 28 women of normal weight, 39 overweight women and 75 obese women with Type 2 diabetes (pre-pregnancy BMI < 25, 25-29.9, ≥ 30 kg/m2, respectively). Gestational weight gain was categorized as excessive (exceeding the US Institute of Medicine recommendations) or as non-excessive (within or below the Institute of Medicine recommendations).
  
  
  RESULTS
  Excessive and non-excessive gestational weight gain were seen in 61 (43%) and 81 women (57%) with a median (range) gestational weight gain of 14.3 (9-32) vs. 7.0 (-5-16) kg (P < 0.001), respectively. Infants of women with excessive gestational weight gain were characterized by higher birth weight (3712 vs. 3258 g; P = 0.001), birth weight z-score (1.14 vs. -0.01, P = 0.001) and prevalence of large-for-gestational-age infants (48 vs. 20%; P < 0.001). In normal weight, overweight and obese women with non-excessive gestational weight gain, the median weight gain in the first half of pregnancy was 371, 114 and 81 g/week, and in the second half of pregnancy 483, 427 and 439 g/week, respectively. In multiple linear regression analysis, gestational weight gain was associated with a higher infant birth weight z-score independent of pre-pregnancy BMI, smoking, HbA1c and insulin dose at last visit, ethnicity and parity [β=0.1 (95% CI 0.06-0.14), P < 0.001].
  
  
  CONCLUSIONS
  Infant birth weight was almost 0.5 kg higher in women with Type 2 diabetes and excessive gestational weight gain than in women with Type 2 diabetes and non-excessive weight gain.
authors: Center for Pregnant Women with Diabetes, University of Copenhagen, Copenhagen, Denmark; Department of Endocrinology, University of Copenhagen, Copenhagen, Denmark.
authors: C B
authors: CB
authors: Parellada
authors: B
authors: B
authors: Asbjörnsdóttir
authors: L
authors: L
authors: Ringholm
authors: P
authors: P
authors: Damm
authors: E R
authors: ER
authors: Mathiesen
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D047109:Fetal Development; D005320:Fetal Macrosomia / Q000453:epidemiology*; D005865:Gestational Age; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007328:Insulin / Q000627:therapeutic use; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011254:Pregnancy in Diabetics; D012189:Retrospective Studies; D015430:Weight Gain; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human