Gestational Weight Gain and Gestational Diabetes Mellitus in Indiana Pregnancies, 2007-2011

BACKGROUND: The percentage of Indiana pregnancies involving gestational diabetes mellitus increased by 1.6% from 2007 to 2011. Due to statewide increases in gestational diabetes mellitus and obesity, the purpose of this study is to examine pre-pregnancy body mass index (BMI), recommended gestational weight gain, and associations related to gestational diabetes mellitus.  

METHODS: Females who had a singleton birth with a recorded pre-pregnancy height and weight, weight at delivery and gestational diabetes mellitus status were identified from Indiana’s birth records 2007-2011. Pre-pregnancy BMI was calculated from self-reported height and weight on birth certificate records. Following Institute of Medicine’s “Weight Gain During Pregnancy: Reexamining the Guidelines” gestational weight gain was calculated and assessed to determine if recommendations were met. Analyses included bivariate analysis and logistic regression.

RESULTS: Between 2007-2011 there were a total of 412,160 females who gave birth in Indiana, 69.9% (n=288,053) of whom did not meet gestational weight gain recommendations. Of these, 5.1% (n=14,611) developed gestational diabetes mellitus. Between 2007-2011, those not meeting gestational weight gain recommendations were 1.08 times more likely to develop gestational diabetes mellitus regardless of pre-pregnancy BMI. Among females who did not meet gestational weight gain recommendations, those with overweight or obese pre-pregnancy BMI were 2.75 times more likely to develop gestational diabetes mellitus than females with a healthy weight or underweight pre-pregnancy BMI. This odds ratio significantly increased from 2.46 [2.25, 2.70] in 2007 to 3.16 [2.90, 3.46] in 2011.

CONCLUSIONS: Between 2007-2011, those not meeting gestational weight gain recommendations were slightly more likely to develop gestational diabetes mellitus. Also, the risk of developing gestational diabetes mellitus in overweight and obese pre-pregnancy BMIs not meeting gestational weight gain recommendations increased significantly over the same period. While preventing gestational diabetes mellitus is important for all women during their pregnancy, physicians should remain more attentive to overweight or obese pregnant females as they have a higher risk of developing gestational diabetes mellitus.