WebMD Health News
Louise Chang, MD
Feb. 22, 2010 -- Women who gain more weight than is recommended
early in pregnancy have an increased risk
for developing gestational diabetes later on, a
Excess weight gain, especially in the first trimester, increased
gestational diabetes risk by about 50%
among the women included in the study.
And overweight women who gained the
most weight in their first and second trimesters were twice as likely to
develop gestational diabetes later in pregnancy as
overweight women who gained the least weight.
Obesity is a well-known risk factor for gestational diabetes, which occurs
in up to 7% of pregnancies in the U.S.
But the study is among the first to link weight gain early in pregnancy to
The study was conducted by the research arm of the California-based managed
care group Kaiser Permanente. It appears in the March issue of Obstetrics
"There has been a dramatic rise in gestational diabetes within the past
decade," study researcher Monique M. Hedderson, PhD, tells WebMD. "Women who
develop gestational diabetes are more likely to have preterm deliveries and
C-sections. And even after delivery they are at increased risk for developing
type 2 diabetes."
Babies born to women with gestational diabetes also have an increased risk
for obesity and diabetes during childhood.
The three-year study included 1,145 women living in northern California who
were followed throughout their pregnancies.
Weight gains were measured in the first trimester and again prior to
screening for gestational diabetes, which typically occurred in the 24th to
28th week of pregnancy.
Actual weight gains were compared to recommended weight gains published by
the health policy group the Institute of Medicine (IOM) in May of last
These guidelines call for weight gains of between 1.1 pounds and 4.4 pounds
in the first trimester of pregnancy, regardless of weight at the beginning of
According to the IOM, normal-weight women should gain between 25 and 35
pounds during pregnancy, while overweight women should gain 15 to 25 pounds and
obese women should gain 11 to 20 pounds.
After adjusting for well-known risk factors for gestational diabetes,
including obesity and older age, women who gained the most weight prior to
diabetes screening were 74% more likely to develop gestational diabetes than
women who gained the least
The risk associated with early pregnancy weight gain seemed to
be higher for black, Hispanic, and Asian women than for white women.
Non-white women in the study who gained the most weight early in pregnancy
had a 2.5-fold increased risk for developing gestational diabetes, compared to
a 1.5-fold increase in risk among white women.
Kaiser Permanente ob-gyn Amanda W. Calhoun, MD, who practices in Richmond,
Calif., tells WebMD the new research will definitely influence how she advises
patients about early pregnancy weight gain.
Calhoun is the co-author of the 2009 book My Pregnancy Pocket
"We've been focused on total weight gain during pregnancy, but not so much
on weight gain early in pregnancy," she says. "This information about the
impact of weight gain in the first trimester is really brand new."
She adds that nutritional counseling early in pregnancy could have a big
impact on increasing gestational diabetes rates.
Among her tips for controlling weight gain during pregnancy:
She also recommends 30 minutes of exercise on most days of the week.
Women who already exercise should continue, but decrease the intensity of their
workouts by about 15%. Women who don't exercise should talk to their health
care provider about starting a program
SOURCES:Hedderson, M.M., Obstetrics & Gynecology, March 2010; vol. 115: pp.
597-604.Monique M. Hedderson, PhD, scientist, Kaiser Permanente Division of
Research, Oakland, Calif.Amanda Williams Calhoun, MD, MPH, ob-gyn, Kaiser Permanente Medical Group,
Richmond Medical Center, Richmond, Calif.; co-author, My Pregnancy Pocket
Guide.News release, Kaiser Permanente.Institute of Medicine: "Weight Gain During Pregnancy: Reexamining the
Guidelines," May 2009.
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