title: Characterizing Gestational Weight Gain According to Institute of Medicine Guidelines in Women with Type 1 Diabetes Mellitus: Association with Maternal and Perinatal Outcome.
abstract: ObjectiveThis study aims to evaluate the association between gestational weight gain (GWG) defined by the current Institute of Medicine (IOM) guidelines and pregnancy outcomes in women with type 1 diabetes mellitus (DM).Study designThis is a secondary analysis of a cohort of 293 pregnancies of women with type 1 DM between 24 and 41 weeks' gestation. Women were categorized according to GWG per week over the second and third trimester: below, within, and above the IOM guidelines. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated for maternal and neonatal outcomes, controlling for covariates and confounders (referent: GWG within the IOM guidelines).ResultsOf the 293 women, there were 49 women (16.7%) with the GWG below the IOM guidelines, 86 women (29.4%) with the GWG within the IOM guidelines, and 158 women (53.9%) with the GWG above the IOM guidelines. Women with the GWG above the IOM guidelines had a higher risk of macrosomia and neonatal hyperbilirubinemia (aOR: 2.78; 95% CI: 1.23-6.30 and 2.31; 1.22-4.35, respectively).ConclusionGWG above the IOM guidelines is associated with an increased risk of macrosomia and neonatal hyperbilirubinemia. Maintaining GWG within the IOM guidelines may decrease the risk of excessive fetal growth and neonatal hyperbilirubinemia in infants of women with type 1 DM.
authors.affiliation: Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kawakita
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Katherine
authors.initials: K
authors.lastname: Bowers
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Ketrell
authors.initials: K
authors.lastname: McWhorter
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mount Sinai West Hospital, New York, New York.
authors.forename: Barak
authors.initials: B
authors.lastname: Rosen
authors.affiliation: Office for Clinical and Translational Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Michelle
authors.initials: M
authors.lastname: Adams
authors.forename: Menachem
authors.initials: M
authors.lastname: Miodovnik
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Jane C
authors.initials: JC
authors.lastname: Khoury
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005320:Fetal Macrosomia / Q000209:etiology; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000209:etiology; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007328:Insulin / Q000008:administration & dosage; D007751:Labor, Induced / Q000706:statistics & numerical data; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D011086:Polycythemia / Q000209:etiology; D017410:Practice Guidelines as Topic; D011225:Pre-Eclampsia / Q000209:etiology; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011254:Pregnancy in Diabetics / Q000188:drug therapy / Q000503:physiopathology*; D011446:Prospective Studies; D014481:United States; D015430:Weight Gain; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin