title: Pre-pregnancy weight change and incidence of gestational diabetes mellitus: A finding from a prospective cohort study.
abstract: OBJECTIVE
  In a population-based cohort study we examined the associations between early adult pre-pregnancy weight change and the risk of gestational diabetes mellitus (GDM).
  
  
  METHODS
  The study included 3111 women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health. These women have been surveyed regularly since 1996. Women without diabetes and GDM were followed-up between 2003 and 2012. Generalized estimating equations were used to assess the effect of baseline (1996, mean age 20years) and pre-pregnancy body mass index (BMI) and the pre-pregnancy weight changes on the incidence of GDM. The full models were adjusted for sociodemographic and lifestyle factors.
  
  
  RESULTS
  From 2003 to 2012, 229GDM cases (4.4%) were reported in 5242 pregnancies. Relative to normal BMI women, obese women at baseline (RR: 1.8, 95% CI: 1.1, 2.8) and prior to pregnancy (RR: 2.7, 95% CI: 2.0, 3.6) were at greater risk of GDM. Weight gains prior to each study pregnancy were strongly associated with increased GDM risk with an adjusted RR ranging from 2.0 to 2.9. Within under/normal range of BMI, women with a moderate/high (>2.5%/year) weight gain had 2.7 (95% CI: 1.3, 5.5) times the risk of GDM compared with women with stable weight.
  
  
  CONCLUSIONS
  Early adult weight gain, even within normal BMI range, is an important risk factor for the development of GDM. Weight gain prevention from early adulthood to prior to pregnancy appears to be the main strategy to prevent the incidence of GDM.
authors.affiliation: Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Australia. Electronic address: a.adane@uq.edu.au.
authors.forename: Akilew Awoke
authors.initials: AA
authors.lastname: Adane
authors.affiliation: Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Australia.
authors.forename: Leigh R
authors.initials: LR
authors.lastname: Tooth
authors.affiliation: Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Australia.
authors.forename: Gita D
authors.initials: GD
authors.lastname: Mishra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D010298:Parity; D011247:Pregnancy; D012307:Risk Factors; D015430:Weight Gain / Q000502:physiology*; D055815:Young Adult
keywords: Early adult; Gestational diabetes mellitus; Incidence; Weight change