title: Excessive gestational weight gain prior to glucose screening and the risk of gestational diabetes: a meta-analysis.
abstract: OBJECTIVE
  Excessive gestational weight gain (GWG) may be a risk factor for gestational diabetes mellitus (GDM). We aimed to study the association between excessive GWG (defined according to Institute of Medicine recommendations) prior to GDM screening, and GDM.
  
  
  METHODS
  We systematically searched four electronic databases from 1990 until September 2014 for observational studies published in English or German that reported an association between excessive GWG and GDM as the outcome. Random effects meta-analyses were performed to provide a pooled estimate of the OR comparing the risk of GDM in women with and without excessive GWG.
  
  
  RESULTS
  A total of eight studies involving 13,748 participants were included. The pooled analysis of unadjusted OR yielded a summary OR of 1.40 (95% CI 1.21, 1.61; p < 0.001) with low between-study heterogeneity (I(2) = 16.7%). A sensitivity analysis based on four studies reporting adjusted effect estimates revealed similar results (OR 1.42; 95% CI 1.20, 1.68; p < 0.001; I(2) = 0%). No evidence was found that the effect of GWG on GDM differs depending on maternal pre-pregnancy BMI category. A funnel plot did not indicate substantial publication bias.
  
  
  CONCLUSIONS
  Avoiding excessive weight gain in pregnancy prior to the GDM screening test may be a potential strategy to reduce GDM risk. META-ANALYSIS REGISTRATION: www.crd.york.ac.uk/PROSPERO CRD42014008802.
authors.affiliation: Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum Rechts der Isar, Technical University of Munich, Uptown Munich Campus D, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Brunner
authors.affiliation: Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum Rechts der Isar, Technical University of Munich, Uptown Munich Campus D, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany.
authors.forename: Lynne
authors.initials: L
authors.lastname: Stecher
authors.affiliation: Division of Epidemiology, Institute of Social Pediatrics and Adolescent Medicine, Ludwig Maximilians University Munich, Munich, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Ziebarth
authors.affiliation: Division of Epidemiology, Institute of Social Pediatrics and Adolescent Medicine, Ludwig Maximilians University Munich, Munich, Germany.
authors.forename: Ina
authors.initials: I
authors.lastname: Nehring
authors.affiliation: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
authors.forename: Sheryl L
authors.initials: SL
authors.lastname: Rifas-Shiman
authors.affiliation: Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.|Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Christine
authors.initials: C
authors.lastname: Sommer
authors.affiliation: Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum Rechts der Isar, Technical University of Munich, Uptown Munich Campus D, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany. hans.hauner@tum.de.
authors.forename: Hans
authors.initials: H
authors.lastname: Hauner
authors.affiliation: Division of Epidemiology, Institute of Social Pediatrics and Adolescent Medicine, Ludwig Maximilians University Munich, Munich, Germany.
authors.forename: Rüdiger
authors.initials: R
authors.lastname: von Kries
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D011247:Pregnancy; D012307:Risk Factors; D015430:Weight Gain / Q000502:physiology*
chemical_list: D001786:Blood Glucose
keywords: GDM; Gestational diabetes; Gestational weight gain; IOM recommendations; Meta-analysis; Pregnancy; Systematic review