Pregnancy weight gain linked to diabetes, as NICE issues draft weight management guidance
Women who put on excessive weight during pregnancy could increase their risk of developing diabetes during the second and third trimester by 74 per cent, according to US research.
The findings, published today in the journal of Obstetrics and Gynaecology, come as NICE issues draft guidance on weight management in pregnancy and after childbirth.
The three-year study of 1,145 pregnant women found that those who are overweight or obese and from ethnic minority groups have the greatest risk of developing gestational diabetes.
Gestational diabetes is known to be associated with complications in pregnancy and can increase a child's risk of developing diabetes and obesity in later life.
For the study, researchers from the Kaiser Permanente Division of Research in Oakland, California, monitored the women for weight gain during pregnancy before screening for gestational diabetes by measuring blood glucose levels.
After adjusting for other diabetes risk factors such as age at delivery, they found that women who gained 0.41 - 0.97 kg/week had a 74 per cent increased risk of developing gestational diabetes compared with women who gained less than 0.27 kg/wk.
Women who were already overweight at the start of pregnancy and gained 0.41 to 0.97 kg/wk had a two-fold increased risk of gestational diabetes.
The researchers say that this study is among the first to support a direct link between pregnancy weight gain and gestational diabetes risk, and hypothesise that weight gain in pregnancy causes insulin resistance that “exhausts” the beta-cells in the pancreas that make and release insulin, which controls levels of glucose in the blood.
Lead researcher Dr Monique Hedderson, said: “Our research shows that weight gain in early pregnancy is a modifiable risk factor for gestational diabetes.”
“Health care providers should talk to their patients early in their pregnancy about the appropriate gestational weight gain and help women monitor their weight gain.”
The NICE draft guidance echoes this and recommends thathealth professionals ensure that women who are pregnant or who are planning a pregnancy and mothers who have had a baby in the last 2 years understand the health risks of being overweight during pregnancy and the importance of achieving a healthy weight prior to pregnancy, and advise them not to try to lose weight while they are pregnant.
Professor Mike Kelly, director of the Centre for Public Health Excellence at NICE said: “Many overweight women have healthy babies, but the evidence does suggest that there are more risks associated with pregnancies in women who have a BMI of over 30. We want all women to be supported before, during and after they have children so that both they and their babies have the healthiest outcome possible.”
The new guidance will be aimed at GPs, obstetricians, midwives, health visitors, dietitians, community pharmacists and all those working in antenatal and postnatal services and children's centres.
The draft recommendations cover four key areas: preparing for pregnancy; pregnant women and women who may become pregnant - particularly those with a BMI over 30kg/m2; and supporting women following childbirth
The draft recommendations are available on the NICE website at: http://guidance.nice.org.uk/PHG/Wave18/3. Anyone wishing to submit comments on the draft guidance is invited to do so via the NICE website between 18 February and 18 March. Final guidance will be published in July.
23 February 2010
This page was last updated: 14 April 2010