Early Pregnancy Weight Gain Predicts Gestational DiabetesWednesday, February 23, 2011
Gestational diabetes and excessive gestational weight gain have significant implications for the health of both mother and child.
Anne-Sophie Morisset and colleagues from Laval University, Quebec City, Canada, now examined the relationship between weight gain early in pregnancy and the risk for gestational diabetes, in a paper just published in the Journal of Womens Health.
The researchers examined data from medical records of women who delivered between January and December 2007 at the Laval University Medical Centre, which included 294 women (55 cases of gestational diabetes and 239 controls).
Weight gain in the first trimester was significantly higher in patients who developed gestational diabetes than in controls (3.4 vs. 1.9 kg), whereas whereas weight gain in the third trimester was significantly lower in diabetes patients compared to controls (4.1 vs. 6.3 kg).
Both prepregnancy BMI and first trimester weight gain were significant and independent predictors of diabetes suggesting that both preconception weight as well as weight gain during the first trimester may warrant greater clinical attention.
This is particularly important given the discussions and concerns about the fetal development theory of epigenetic program, which many today believe to be one of the key drivers of childhood obesity.
Morisset AS, Tchernof A, Dubé MC, Veillette J, Weisnagel SJ, & Robitaille J (2011). Weight Gain Measures in Women with Gestational Diabetes Mellitus. Journal of women’s health (2002) PMID: 21332414
Wednesday, February 23, 2011
It seems to me that women who dieted pre-pregnancy are the ones who are most likely to gain weight quickly in the first trimester.
Also, I believe there’s evidence based on studies of the Dutch famine of 1944 that suggests that the children of women who don’t get enough to eat during pregnancy (presumably because of trying to avoid weight gain as well as an actual famine) tend to have higher BMIs as adults. That makes sense from a evolutionary point of view, as fetuses that expect to be born into a world without adequate food might develop slower metabolisms.
Wednesday, February 23, 2011
To add to DeeLeigh’s comments, apparently the same phenomenon has been observed in children born to mothers during the Biafran famine.
In response to the findings you report, Dr. Sharma, I have to wonder about the reason for the weight gain. As we know, insulin resistance plays a factor in weight management. If the pregnant woman has an insulin-related problem, couldn’t that be the real reason she gains so much weight and develops gestational diabetes?
Unfortunately, the results of the study you cite may lead some women to intentionally under-nourish themselves in the vain hope of not developing diabetes and in so doing, as DeeLeigh points out, they may actually be setting up their babies for weight problems later in life.