Abstract
Objective:
In a multi-ethnic population-based study, we investigate the change in indicators of adiposity (being weight gain and gain of total fat, truncal fat and mean skinfold thickness) from early pregnancy to 28 weeks of gestation overall and across ethnic groups, and explore the association between the change in indicators of adiposity and gestational diabetes (GDM).
Design:
Weight, skinfold thickness and bioelectrical impedance analysis were performed twice in 728 pregnant women in gestational week 15 (visit 1) and week 28 (visit 2). GDM was defined by the modified International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria (1-hour glucose not available).
Results:
An increase in all indicators of adiposity gave increased odds ratios (OR) for GDM. After adjusting for pre-pregnant body mass index, a 0.14 kg per week (one standard deviation (s.d.)) increase in truncal fat gave an OR of 1.31 (95% CI 1.10–1.56), while a 0.21 kg per week (one s.d.) weight gain gave an OR of 1.23 (95% CI 1.04–1.46) for GDM. The ORs for the indicators of adiposity remained after additional adjustments for insulin resistance in early pregnancy. When combining the effects of an ethnic origin, 0.14 kg per week (one s.d.) truncal fat gain and 4.7 kg m−2 (one s.d.) increased pre-pregnant BMI the OR for South Asians was 5.9 (3.5–10.0) versus 2.1 (1.6–2.8) for Europeans.
Conclusion:
Weight gain and gain of total fat mass, mean skinfold thickness and especially truncal fat were all positively associated with GDM. South Asians, in particular, should be encouraged to avoid an excessive weight gain during pregnancy to reduce risk of GDM.
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References
O'Sullivan JB, Gellis SS, Dandrow RV, Tenney BO . The potential diabetic and her treatment in pregnancy. Obstet Gynecol 1966; 27: 683–689.
Kim C, Newton KM, Knopp RH . Gestational diabetes and the incidence of Type 2 diabetes. A systematic review. Diabetes Care 2002; 25: 1862–1868.
Benhalima K, Hanssens M, Devlieger R, Verhaeghe J, Mathieu C . Analysis of pregnancy outcomes using the new IADPSG recommendation compared with the Carpenter and Coustan Criteria in an area with a low prevalence of gestational diabetes. Int J Endocrinol 2013; 2013: 248121.
Wendland EM, Torloni MR, Falavigna M, Trujillo J, Dode MA, Campos MA et al. Gestational diabetes and pregnancy outcomes-a systematic review of the World Health Organization (WHO) and the International Association of Diabetes in Pregnancy Study Groups (IADPSG) diagnostic criteria. BMC Pregnancy Childbirth 2012; 12: 23.
Dabelea D . The predisposition to obesity and diabetes in offspring of diabetic mothers. Diabetes Care 2007; 30 (Supplement 2): S169–S174.
WHO. Global Health Observatory; Obesity 2013, http://www.who.int/gho/ncd/risk_factors/obesity_text/en/index.html.
Norman JE, Reynolds RM . The consequences of obesity and excess weight gain in pregnancy. Proc Nutr Soc 2011; 70: 450–456.
Torloni MR, Betrán AP, Horta BL, Nakamura MU, Atallah AN, Moron AF et al. Prepregnancy BMI and the risk of gestational diabetes: a systematic review of the literature with meta-analysis. Obes Rev 2009; 10: 194–203.
Institute of Medicine. Weight Gain During Pregnancy: Reexamining the Guidelines. National Academy of Sciences: Washington, DC, 2009.
Baci Y, Ustuner I, Keskin HL, Ersoy R, Avsar AF . Effect of maternal obesity and weight gain on gestational diabetes mellitus. Gynecol Endocrinol 2013; 29: 133–136.
Poston L . Gestational weight gain: influences on the long-term health of the child. Curr Opin Clin Nutr Metab Care 2012; 15: 252–257.
Siega-Riz AM, Viswanathan M, Moos M-K, Deierlein A, Mumford S, Knaack J et al. A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: birthweight, fetal growth, and postpartum weight retention. Am J Obstet Gynecol 2009; 201: 339.e1–339.e14.
Freemantle N, Holmes J, Hockey A, Kumar S . How strong is the association between abdominal obesity and the incidence of type 2 diabetes? Int J Clin Pract 2008; 62: 1391–1396.
Jenum AK, Diep LM, Holmboe-Ottesen G, Holme IM, Kumar BN, Birkeland KI . Diabetes susceptibility in ethnic minority groups from Turkey, Vietnam, Sri Lanka and Pakistan compared with Norwegians—the association with adiposity is strongest for ethnic minority women. BMC Public Health 2012; 12: 150.
Jenum AK, Morkrid K, Sletner L, Vangen S, Torper JL, Nakstad B et al. Impact of ethnicity on gestational diabetes identified with the WHO and the modified International Association of Diabetes and Pregnancy Study Groups criteria: a population-based cohort study. Eur J Endocrinol 2012; 166: 317–324.
Jenum AK, Sletner L, Voldner N, Vangen S, Morkrid K, Andersen LF et al. The STORK Groruddalen research programme: a population-based cohort study of gestational diabetes, physical activity and obesity in pregnancy in a multiethnic population. Rationale, methods, study population and participation rates. Scand J Public Health 2010; 38: 60–70.
Volgyi E, Tylavsky FA, Lyytikainen A, Suominen H, Alen M, Cheng S . Assessing body composition with DXA and bioimpedance: effects of obesity, physical activity, and age. Obesity (Silver Spring) 2008; 16: 700–705.
McCarthy EA, Strauss BJ, Walker SP, Permezel M . Determination of maternal body composition in pregnancy and its relevance to perinatal outcomes. Obstet Gynecol Surv 2004; 59: 731–742 (quiz 745–6).
Ulijaszek SJ, Kerr DA . Anthropometric measurement error and the assessment of nutritional status. Br J Nutr 1999; 82: 165–177.
Sletner L, Nakstad B, Yajnik CS, Mørkrid K, Vangen S, Vårdal MH et al. Ethnic differences in neonatal body composition in a multi-ethnic population and the impact of parental factors: a population-based cohort study. PLoS One 2013; 8: e73058.
Mørkrid K, Jenum AK, Sletner L, Vårdal MH, Waage CW, Nakstad B et al. Failure to increase insulin secretory capacity during pregnancy-induced insulin resistance is associated with ethnicity and gestational diabetes. Eur J Endocrinol 2012; 167: 579–588.
Petry CJ . Gestational diabetes: risk factors and recent advances in its genetics and treatment. Br J Nutr 2010; 104: 775–787.
Martin AM, Berger H, Nisenbaum R, Lausman AY, MacGarvie S, Crerar C et al. Abdominal visceral adiposity in the first trimester predicts glucose intolerance in later pregnancy. Diabetes Care 2009; 32: 1308–1310.
Suresh A, Liu A, Poulton A, Quinton A, Amer Z, Mongelli M et al. Comparison of maternal abdominal subcutaneous fat thickness and body mass index as markers for pregnancy outcomes: a stratified cohort study. Aust N Z J Obstet Gynaecol 2012; 52: 420–426.
Brisson D, Perron P, Guay SP, Gaudet D, Bouchard L . The ‘hypertriglyceridemic waist’ phenotype and glucose intolerance in pregnancy. CMAJ 2010; 182: E722–E725.
Bhopal RS . A four-stage model explaining the higher risk of Type 2 diabetes mellitus in South Asians compared with European populations. Diabet Med 2013; 30: 35–42.
Sniderman AD, Bhopal R, Prabhakaran D, Sarrafzadegan N, Tchernof A . Why might South Asians be so susceptible to central obesity and its atherogenic consequences? The adipose tissue overflow hypothesis. Int J Epidemiol 2007; 36: 220–225.
Ronnberg AK, Nilsson K . Interventions during pregnancy to reduce excessive gestational weight gain: a systematic review assessing current clinical evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. BJOG 2010; 117: 1327–1334.
Thangaratinam S, Rogozinska E, Jolly K, Glinkowski S, Roseboom T, Tomlinson JW et al. Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. Br Med J 2012; 344: e2088.
Oteng-Ntim E, Varma R, Croker H, Poston L, Doyle P . Lifestyle interventions for overweight and obese pregnant women to improve pregnancy outcome: systematic review and meta-analysis. BMC Med 2012; 10: 47.
Gould Rothberg BE, Magriples U, Kershaw TS, Rising SS, Ickovics JR . Gestational weight gain and subsequent postpartum weight loss among young, low-income, ethnic minority women. Am J Obstet Gynecol 2011; 204: 52 e1–11.
Deurenberg P, Deurenberg-Yap M, Guricci S . Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship. Obes Rev 2002; 3: 141–146.
Committee A-PS, Bassett J, Organization WH, Obesity IAftSo, Institute ID, Force IOT. The Asia-Pacific Perspective: Redefining Obesity and Its Treatment. Health Communications: Australia, 2000.
Boffetta P, McLerran D, Chen Y, Inoue M, Sinha R, He J et al. Body mass index and diabetes in Asia: a cross-sectional pooled analysis of 900 000 individuals in the Asia cohort consortium. PLoS One 2011; 6: e19930.
Acknowledgements
The STORK Groruddalen study was funded by the Norwegian Research Council, the South-Eastern Norway Regional Health Authority, the Norwegian Directorate of Health and collaborative partners in the city of Oslo, Stovner, Grorud and Bjerke administrative districts.
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Sommer, C., Mørkrid, K., Jenum, A. et al. Weight gain, total fat gain and regional fat gain during pregnancy and the association with gestational diabetes: a population-based cohort study. Int J Obes 38, 76–81 (2014). https://doi.org/10.1038/ijo.2013.185
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DOI: https://doi.org/10.1038/ijo.2013.185
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