Interpregnancy Weight Change and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

Abstract

Background: Evidence supports the relationship between pre-pregnancy body mass index (BMI) and gestational diabetes mellitus (GDM). However, the association between interpregnancy weight change (IPWC) and GDM in the subsequent pregnancy has been studied less. The purpose of this study was to conduct a systematic review and meta-analysis to synthesize evidence on the association between IPWC and GDM in the subsequent pregnancy. Methods: MEDLINE, EMBASE, Cochrane Library and Web of Science were searched from inception through 16 September 2019. The most adjusted relative risk (RR) or odds ratios (OR) and their corresponding 95% confidence intervals (CIs) reported by studies included were used. The ‘no weight change’ category defined by each study was used as the reference category. Findings: 13 articles were included in this systematic review and meta-analyses with a total sample of 529.080 women. The analyses showed higher risk of GDM in the subsequent pregnancy among women with interpregnancy weigh gain (OR = 1.56; 95% CI: 1.30-1.83; I2 = 82.30%; p = <0.001). Interpregnancy weight loss decreased the risk of GDM in the subsequent pregnancy (OR = 0.83; 95% CI: 0.68-0.98; I2 = 58.10%; p = 0.01). particularly. among women with pre-gestational BMI greater than 25 (OR = 0.58; 95% CI: 0.39-0.77; I2 = 0.00%; p = 0.64). Interpretation: IPWC is associated with risk of GDM in the subsequent pregnancy. Consequently, lifestyle interventions aimed at weight management during pregnancy and the postpartum period could improve perinatal outcomes in the subsequent pregnancy. Funding Statement: This study did not receive any funding. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (Registration number: CRD42018100449) and its protocol has been published.