Pregnancy weight gain and nutritional therapy on the outcome of gestational diabetes mellitus

Abstract

To study the relationship of bodyweight gain and the occurrence of gestational diabetes mellitus (GDM) during pregnancy, and analyze the effect of the nutritional therapy on the outcome of GDM. We collected 265 pregnant women who were diagnosed to be GDM and 571 pregnant women as the control group in the Xiamen Maternal and Child Health Hospital during 2007 - 2009. The general information of the subjects were collected. The bodyweight of the subjects were measured before the 20(th) week of pregnancy, 26 - 27(th) week (mid-gestation), 35 - 36(th) week (late-gestation) of pregnancy and prior to delivery. The bodyweight gain of different pregnancy weeks of the two groups and the effect of bodyweight on GMD occurrence before 28(th) week of pregnancy were analyzed by ages (< 25, 25-, 30-, ≥ 35). Meanwhile, we prescribed the nutrition therapy to the GDM pregnant woman and the effect of the blood sugar control on the outcome of the pregnancy were evaluated. The bodyweight gain of 25-, 30-, older than 35 year-old subjects of the GDM group were (16.9 ± 6.3), (16.8 ± 6.1), (16.5 ± 6.0) kg, respectively, the bodyweight gain of the control group were (13.9 ± 3.0), (13.8 ± 2.7), (13.3 ± 2.7) kg (t = 6.259, 5.885, 3.533, respectively, all P values < 0.05). During the 20(th) to 27(th) week of the pregnancy, the bodyweight gain of the subjects younger than 25, 25-, 30-year-old in GDM group were (5.2 ± 1.0), (5.4 ± 1.7), (4.8 ± 1.3) kg, respectively, the bodyweight gain of the control group were (3.3 ± 1.3), (3.7 ± 1.6) and (3.5 ± 0.7) kg (t = 5.026, 9.659, 11.19, respectively, all P values < 0.05). During the period between 26(th) to 36(th) week, the bodyweight gain of subjects older than 35 year-old in GDP group was (3.6 ± 2.0) kg which was less than the control group ((4.0 ± 0.9) kg, t = -2.449, P < 0.05). 41.22% (54/131) and 44.94% (40/89) of 25-, 30-year-old subjects in GDM group showed bodyweight gain more than 13 kg, but 30.04% (76/253) and 26.07% (55/211) in the control group (OR values were 1.633 and 2.315, both P values < 0.05). The rate of the abnormal birth weight of the GDM group with blood sugar controlled and the control group were 6.6% (12/182) and 9.4% (54/571) which was lower than the GDP group with blood sugar control failure (20.5% (17/83)) (χ(2) values were 11.460, 9.119, respectively, both P values < 0.0125). The rate of premature delivery was 21.7%(18/83), higher than the control group (10.8%, 62/571) (χ(2) = 7.945, P < 0.0125). The rate of the cesarean in the control group was 25.4%(145/571) which was lower than the two GDM groups, including the group which the blood sugar was well controlled (46.7%, 85/182) and not well controlled (65.0%, 54/83) (χ(2) values were 29.540, 53.860, respectively, both P values < 0.0125). The bodyweight gain in the mid-gestation could affect the occurrence of GDM. The bodyweight gain should be less than 13 kg before 28(th) week of the pregnancy whose age was 25-year-old. Nutritional therapy and blood sugar control in GDM pregnant women could improve the pregnancy outcome.