title: Weight gain adequacy and pregnancy outcomes in gestational diabetes: a meta-analysis.
abstract: The Institute of Medicine updated guidelines for gestational weight gain in 2009, with no special recommendations for gestational diabetes. Our objectives were to describe the prevalence of weight gain adequacy and their association with adverse pregnancy outcomes in gestational diabetes. We searched MEDLINE, EMBASE, COCHRANE and SCOPUS. We calculated the pooled prevalence of gain adequacy and relative risks for pregnancy outcomes within Institute of Medicine categories. Thirty-three studies/abstracts (88,599 women) were included. Thirty-one studies provided data on the prevalence of weight gain adequacy; it was adequate in 34% (95% CI: 29-39%) of women, insufficient in 30% (95% CI: 27-34%) and excessive in 37% (95% CI: 33-41%). Excessive gain was associated with increased risks of pharmacological treatment, hypertensive disorders of pregnancy, caesarean section, large for gestational age and macrosomic babies, compared to adequate or non-excessive gain. Weight gain below the guidance had a protective effect on large babies (RR: 0.71; 95% CI: 0.56-0.90) and macrosomia (RR 0.57; 95% CI 0.40-0.83), and did not increase the risk of small babies (RR 1.40; 95% CI 0.86-2.27). Less than recommended weight gain would be beneficial, while effective prevention of excessive gain is of utmost importance, in gestational diabetes pregnancies. Nevertheless, no ideal range for weight gain could be established.
authors.affiliation: Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
authors.forename: C
authors.initials: C
authors.lastname: Viecceli
authors.affiliation: Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
authors.forename: L R
authors.initials: LR
authors.lastname: Remonti
authors.affiliation: Biostatistics Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
authors.forename: V N
authors.initials: VN
authors.lastname: Hirakata
authors.affiliation: Post-graduate Course in Medical Sciences: Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: L S
authors.initials: LS
authors.lastname: Mastella
authors.affiliation: Post-graduate Course in Medical Sciences: Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: V
authors.initials: V
authors.lastname: Gnielka
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: M L R
authors.initials: ML
authors.lastname: Oppermann
authors.affiliation: Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.|Post-graduate Course in Medical Sciences: Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.|Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: S P
authors.initials: SP
authors.lastname: Silveiro
authors.affiliation: Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
authors.forename: A J
authors.initials: AJ
authors.lastname: Reichelt
mesh_terms: D001724:Birth Weight; D016640:Diabetes, Gestational / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007236:Infant, Small for Gestational Age; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D016032:Randomized Controlled Trials as Topic; D014481:United States; D015430:Weight Gain
keywords: Gestational diabetes; Institute of Medicine recommendations; pregnancy outcomes; weight gain