Preventing large birth size in women with preexisting diabetes mellitus: The benefit of appropriate gestational weight gain

Details

• Alternative Title:
  Prev Med
• Personal Author:
  Kim, Shin Y. ; Sharma, Andrea J. ; Sappenfield, William ; Salihu, Hamisu M.
• Description:
  Objective
  
  To estimate the percentage of infants with large birth size attributable to excess gestational weight gain (GWG), independent of prepregnancy body mass index, among mothers with preexisting diabetes mellitus (PDM).
  
  Study design
  
  We analyzed 2004–2008 Florida linked birth certificate and maternal hospital discharge data of live, term (37–41 weeks) singleton deliveries (N = 641,857). We calculated prevalence of large-for-gestational age (LGA) (birth weight-for-gestational age ≥ 90th percentile) and macrosomia (birth weight > 4500 g) by GWG categories (inadequate, appropriate, or excess). We used multivariable logistic regression to estimate the relative risk (RR) of large birth size associated with excess compared to appropriate GWG among mothers with PDM. We then estimated the population attributable fraction (PAF) of large birth size due to excess GWG among mothers with PDM (n = 4427).
  
  Results
  
  Regardless of diabetes status, half of mothers (51.2%) gained weight in excess of recommendations. Large birth size was higher in infants of mothers with PDM than in infants of mothers without diabetes (28.8% versus 9.4% for LGA, 5.8% versus 0.9% for macrosomia). Among women with PDM, the adjusted RR of having an LGA infant was 1.7 (95% CI 1.5, 1.9) for women with excess GWG compared to those with appropriate gain; the PAF was 27.7% (95% CI 22.0, 33.3). For macrosomia, the adjusted RR associated with excess GWG was 2.1 (95% CI 1.5, 2.9) and the PAF was 38.6% (95% CI 24.9, 52.4).
  
  Conclusion
  
  Preventing excess GWG may avert over one-third of macrosomic term infants of mothers with PDM. Effective strategies to prevent excess GWG are needed.
  
  
• Subjects:
  Adult Article Birth Weight Diabetes Mellitus Female Fetal Macrosomia Florida Gestational Weight Gain Humans LGA Macrosomia Mothers Obesity Preexisting Diabetes Pregnancy Prevalence Retrospective Studies Weight Gain

  More +
• Source:
  Prev Med. 91:164-168
• Pubmed ID:
  27539071
• Pubmed Central ID:
  PMC5050147
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Volume:
  91
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:3fa4a431863af4211863594c974e80beb2d63c26ea596fa82a3f1eed6c3af3d7
• Download URL:
  https://stacks.cdc.gov/view/cdc/42175/cdc_42175_DS1.pdf
• File Type:
  [PDF - 424.57 KB ]