Weight Categories, Trajectories, Eating Behavior, and Metabolic Consequences during Pregnancy and Postpartum in Women with GDM

Author:

Schenk Sybille12,Ravussin Yann3ORCID,Lacroix Alain4,Quansah Dan Yedu2ORCID,Puder Jardena J.2ORCID

Affiliation:

1. Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland

2. Obstetric Service, Department Woman-Mother-Child, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland

3. Department of Endocrinology, Metabolism and Cardiovascular System, Medicine Section, University of Fribourg, 1700 Fribourg, Switzerland

4. Institute of Higher Education and Research in Healthcare, University of Lausanne, 1010 Lausanne, Switzerland

Abstract

Pre-pregnancy overweight and obesity are associated with increased risk for adverse outcomes, such as gestational diabetes mellitus (GDM). This study investigated weight trajectories, eating behaviors, and metabolic consequences in women with GDM during pregnancy and postpartum according to pre-pregnancy BMI. We prospectively included 464 women with GDM. Intuitive eating (Intuitive Eating Scale-2 questionnaire), gestational weight gain (GWG), postpartum weight retention (PPWR) at 6–8 weeks and 1-year postpartum, and glucose intolerance (prediabetes and diabetes) at 1-year were assessed. Women with obesity (WOB) had lower GWG but gained more weight in the postpartum (p < 0.0001). PPWR at 1-year did not differ across BMI categories (p = 0.63), whereas postpartum weight loss was most pronounced in women with normal weight (p < 0.0001), and within this category, in their lowest tertile (p < 0.05). Intuitive eating was not linked to perinatal weight changes but differed among BMI categories. PPWR predicted a 2.5-fold increased risk of glucose intolerance at 1-year independent of pre-pregnancy BMI (p < 0.001), and the adverse metabolic impact of PPWR was most pronounced in WOB with odds of increased risk of glucose intolerance 8.9 times higher (95% CI 2.956;26.968). These findings suggest an adaptive capacity to relatively rapid weight changes in the perinatal period that is less present with higher BMI.

Funder

Swiss National Science Foundation

Publisher

MDPI AG

Reference61 articles.

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