title: [Association between gestational weight gain per trimester/total gestational weight gain and gestational diabetes mellitus].
abstract: Objective:To understand the association between gestational weight gain (GWG) per trimester/total (GWG) and gestational diabetes mellitus (GDM).Methods:A prospective cohort study was conducted among 829 healthy pregnant women from Chengdu who delivered a singleton during March-September 2013. Basic information about pre-pregnancy was collected at the first time, exercise information per trimester, dietary intake information per trimester and gestational age at delivery were obtained by questionnaire. Weight at the (12 ± 1)th, (28 ± 1)th, (36 ± 1)thand last week before delivery were measured. GDM was diagnosed according to the National Diabetes and Pregnancy Prevention Guidelines (2014). At last, a total of 682 pregnant women were analyzed. After controlling the potential confounders, multiple logistic regression models were used to test the associations between GWG per trimester/total GWG and GDM.Results:After adjusting for age at delivery, pre-pregnancy body mass index, family histories of type 2 diabetes and hypertension, exercise in the first trimester, parity and energy intake in trimester and other potential confounders. Compared with adequate GWG in the first trimester, insufficient and excessive GWG in the first trimester were associated with increased risk of GDM (OR=1.23, 95%CI: 0.63-2.38, andOR=2.20, 95%CI: 1.12-4.35). Compared with adequate GWG in the second trimester, insufficient and excessive GWG in the second trimester were associated with decreased risk of GDM (OR=0.47, 95%CI: 0.18-1.19, andOR=0.78, 95% CI: 0.43-1.42). Compared with adequate GWG in the third trimester, insufficient GWG in the third trimester was associated with increased risk of GDM (OR=1.48, 95%CI: 0.77-2.84), excessive GWG in the third trimester was associated with decreased risk of GDM (OR= 0.53, 95% CI: 0.28-0.99). Compared with adequate total GWG in pregnancy, insufficient GWG in pregnancy was associated with increased risk of GDM (OR=2.16, 95% CI: 1.04-4.46), excessive GWG in pregnancy was associated with decreased risk of GDM (OR=0.74, 95% CI: 0.38-1.46).Conclusions:Insufficient and excessive GWG in the first trimester were associated with increased risk of GDM, the first trimester may represent a critical period for risk of GDM. The effects of GWG in the second and third trimester on GDM need further study.
authors.affiliation: Department of Nutrition, Food Hygiene and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China.
authors.forename: Z Y
authors.initials: ZY
authors.lastname: Dai
authors.affiliation: Department of Nutrition, Food Hygiene and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China.
authors.forename: D
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Nutrition, Food Hygiene and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China.
authors.forename: R
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Nutrition, Food Hygiene and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Health Care, Maternity and Child Health Care Central Hospital of Sichuan, Chengdu 610045, China.
authors.forename: J
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Women Health Care, Women and Children's Central Hospital of Chengdu, Chengdu 610091, China.
authors.forename: J
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Obstetrics, West China Second University Hospital/West China Women's and Children's Hospital, Chengdu 610041, China.
authors.forename: R
authors.initials: R
authors.lastname: Zhou
authors.affiliation: Department of Nutrition, Food Hygiene and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China.
authors.forename: G
authors.initials: G
authors.lastname: Zeng
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2; D016640:Diabetes, Gestational / Q000453:epidemiology*; D002149:Energy Intake; D015444:Exercise; D005260:Female; D005865:Gestational Age; D006801:Humans; D016015:Logistic Models; D010298:Parity; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D015430:Weight Gain