Association between Prepregnancy Weight Change and Risk of Gestational Diabetes Mellitus in Chinese Pregnant Women

Jing Ouyang; Yuwei Lai; Linjing Wu; Yi Wang; Ping Wu; Yi-Xiang Ye; Xue Yang; Yanyu Gao; Jiaying Yuan; Xingyue Song; Shijiao Yan; Chuanzhu Lv; Yi-Xin Wang; Gang Liu; Yayi Hu; An Pan; Xiong-Fei Pan

doi:10.1016/j.ajcnut.2023.04.016

Association between Prepregnancy Weight Change and Risk of Gestational Diabetes Mellitus in Chinese Pregnant Women

Am J Clin Nutr. 2023 Jun;117(6):1353-1361. doi: 10.1016/j.ajcnut.2023.04.016. Epub 2023 Apr 15.

Authors

Jing Ouyang¹, Yuwei Lai¹, Linjing Wu¹, Yi Wang¹, Ping Wu¹, Yi-Xiang Ye¹, Xue Yang², Yanyu Gao³, Jiaying Yuan⁴, Xingyue Song⁵, Shijiao Yan⁶, Chuanzhu Lv⁷, Yi-Xin Wang¹, Gang Liu⁸, Yayi Hu⁹, An Pan¹⁰, Xiong-Fei Pan¹¹

Affiliations

¹ Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Section of Epidemiology and Population Health & Department of Obstetrics and Gynecology, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & National Medical Products Administration Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, West China Second University Hospital, Sichuan University, Chengdu, China.
³ Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
⁴ Department of Science and Education, Shuangliu Maternal and Child Health Hospital, Chengdu, China.
⁵ Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, China.
⁶ School of Public Health, Hainan Medical University, Haikou, China; Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences, Hainan Medical University, Haikou, China.
⁷ Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences, Hainan Medical University, Haikou, China; Emergency Medicine Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China.
⁸ Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁹ Department of Obstetrics and Gynecology, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, China.
¹⁰ Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: [email protected].
¹¹ Section of Epidemiology and Population Health & Department of Obstetrics and Gynecology, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & National Medical Products Administration Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, West China Second University Hospital, Sichuan University, Chengdu, China; Shuangliu Institute of Women's and Children's Health, Shuangliu Maternal and Child Health Hospital, Chengdu, China; Center for Epidemiology and Population Health, Integrated Traditional Chinese and Western Medicine Institute & Chengdu Integrated Traditional Chinese and Western Medicine Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China. Electronic address: [email protected].

PMID: 37062367
DOI: 10.1016/j.ajcnut.2023.04.016

Abstract

Background: Evidence regarding prepregnancy weight change and gestational diabetes mellitus (GDM) is lacking among East Asian women.

Objectives: Our study aimed to investigate the association between weight change from age 18 y to pregnancy and GDM in Chinese pregnant women.

Methods: Our analyses included 6972 pregnant women from the Tongji-Shuangliu Birth Cohort. Body weights were recalled for age 18 y and the time point immediately before pregnancy, whereas height was measured during early pregnancy. Prepregnancy weight change was calculated as the difference between weight immediately before pregnancy and weight at age 18 y. GDM outcomes were ascertained by 75-g oral-glucose-tolerance test. Multivariable logistic regression models were used to examine the association between prepregnancy weight change and risk of GDM.

Results: In total, 501 (7.2%) developed GDM in the cohort. After multivariable adjustments, prepregnancy weight change was linearly associated with a higher risk of GDM (P < 0.001). Compared with participants with stable weight (weight change within 5.0 kg) before pregnancy, multivariable-adjusted odds ratios and 95% confidence intervals were 1.55 (1.22, 1.98) and 2.24 (1.78, 2.83) for participants with moderate (5-9.9 kg) and high (≥10 kg) weight gain, respectively. In addition, overweight/obesity immediately before pregnancy mediated 17.6% and 31.7% of the associations of moderate and high-weight gain with GDM risk, whereas weekly weight gain during pregnancy mediated 21.1% and 22.7% of the associations.

Conclusions: Weight gain from age 18 y to pregnancy was significantly associated with a higher risk of GDM. Maintaining weight stability, especially prevention of excessive weight gain from early adulthood to pregnancy, could be a potential strategy to reduce GDM risk.

Keywords: Chinese pregnant women; birth cohort; body mass index; gestational diabetes mellitus; prepregnancy weight change.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Body Mass Index
Diabetes, Gestational*
East Asian People
Female
Humans
Overweight / complications
Pregnancy
Pregnant People
Risk Factors
Weight Gain*
Young Adult