Relationship between the weight gain in the first and second trimesters and gestational glucose metabolism

Abstract

Objective To study the difference of body weight gain in the first and second trimesters between pregnant women with abnormal gestational glucose metabolism and those with normal gestational glucose metabolism. Methods We retrospectively analyzed the data of pregnant women visited the obstetric clinic of Peking Union Medical College Hospital from January 2010 to May 2011, with or without abnormal glucose metabolism. The data of body weight gain in the first and second trimesters, body mass index (BMI) before pregnancy, BMI in the end of second trimester, age, obesity history, diabetes family history, insulin level in the oral glucose tolerance test (OGTT), and lipid profile of these women were collected. Results Altogether 216 pregnant women with abnormal glucose metabolism (case group) and 230 pregnant women with normal glucose metabolism (control group) were included in this study. In the case group, the increment of body weight in the first and second trimesters was 10.0(8.1, 12.5)kg, and the increment of BMI was (4.01±1.43)kg/m2, BMI in the end of the second trimester was (25.84±3.14)kg/m2; in comparison, the increments of body weight and BMI in the first and second trimesters were 9.5 (7.0, 11.5)kg and (3.60±1.43)kg/m2, respectively, BMI in the end of the second trimester was (25.1 ±3.00)kg/m2 in the control group, all significantly lower than in the case group (all P 0.05). Compare with the control group, the case group had older age [(33.17±3.65)years vs. (31.68±3.36)years], higher fasting insulin level [11.2 (7.1, 16.3)mU/L vs. 8.9 (6.5, 13.7)mU/L], higher peak insulin level in OGTT [135.3(99.7, 208.0)mU/L vs. 104.9(75.6, 144.4)mU/L], higher homeostasis model assessment for insulin resistance (HOMA-IR)[2.40(1.49, 3.47) vs. 1.82(1.28, 2.71)], and triglyceride [2.62(2.04, 3.31)mmol/L vs. 2.18(1.81, 2.81)mmol/L], all with significant differences (all P 0.05). Conclusions The body weight gain is higher in the pregnant women with abnormal glucose metabolism than in those with normal glucose metabolism in the first and second trimesters. Large increment of body weight is likely to be a risk factor for abnormal gestational glucose metabolism. Key words: Gestational diabetes mellitus; Gestational weight gain; Body mass index