Association between gestational weight gain, gestational diabetes risk, and obstetric outcomes : A randomized controlled trial post hoc analysis
Simmons, David (Western Sydney University)
Devlieger, Roland (GasthuisZusters Antwerpen Sint-Augustinus)
van Assche, Andre (KU Leuven)
Galjaard, Sander (University Medical Centre Rotterdam)
Corcoy i Pla, Rosa (Institut d'Investigació Biomèdica Sant Pau)
Adelantado, Juan M (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Dunne, Fidelma (National University of Ireland)
Desoye, Gernot (Medizinische Universitaet Graz)
Kautzky-Willer, Alexandra (Addenbrookes Hospital (Cambridge, Regne Unit))
Damm, Peter (University of Copenhagen)
Mathiesen, Elisabeth R. (University of Copenhagen)
Jensen, Dorte M. (University of Southern Denmark)
Andersen, Lise-Lotte (University of Southern Denmark)
Lapolla, Annunziata (Università degli Studi di Padova)
Dalfra, Maria Grazia (Università degli Studi di Padova)
Bertolotto, Alessandra (University of Pisa)
Wender-Ozegowska, Ewa (Poznan University of Medical Sciences)
Zawiejska, Agnieszka (Poznan University of Medical Sciences)
Hill, David (Recherche en Santé Lawson SA)
Snoek, Frank J. (Vrije Universiteit Amsterdam)
van Poppel, M.N.M (University of Graz)
Universitat Autònoma de Barcelona

Data:	2018
Resum:	Excess gestational weight gain (GWG) is associated with the development of gestational diabetes mellitus (GDM). Lifestyle trials have not achieved much GWG limitation, and have largely failed to prevent GDM. We compared the effect of substantial GWG limitation on maternal GDM risk. Pregnant women with a body mass index (BMI) ≥29 kg/m <20 weeks gestation without GDM (n = 436) were randomized, in a multicenter trial, to usual care (UC), healthy eating (HE), physical activity (PA), or HE and PA lifestyle interventions. GWG over the median was associated with higher homeostasis model assessment insulin resistance (HOMA-IR) and insulin secretion (Stumvoll phases 1 and 2), a higher fasting plasma glucose (FPG) at 24-28 weeks (4. 66 ± 0. 43 vs. 4. 61 ± 0. 40 mmol/L, p < 0. 01), and a higher rate of caesarean section (38% vs. 27% p < 0. 05). The GWG over the median at 35-37 weeks was associated with a higher rate of macrosomia (25% vs. 16%, p < 0. 05). A post hoc comparison among women from the five sites with a GWG difference >3 kg showed no significance difference in glycaemia or insulin resistance between HE and PA, and UC. We conclude that preventing even substantial increases in GWG after the first trimester has little effect on maternal glycaemia. We recommend randomized controlled trials of effective lifestyle interventions, starting in or before the first trimester.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Gestational diabetes mellitus ; Healthy eating ; Lifestyle intervention ; Motivational interviewing ; Overweight ; Physical activity ; Pregnancy ; Prevention ; Randomised controlled trial
Publicat a:	Nutrients, Vol. 10 Núm. 11 (november 2018) , p. 1568, ISSN 2072-6643

DOI: 10.3390/nu10111568
PMID: 30360536

13 p, 429.7 KB

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