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J Perinatol. 2013 Dec;33(12):929-33. doi: 10.1038/jp.2013.100. Epub 2013 Aug 15.

Gestational weight gain in insulin-resistant pregnancies.

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  • 1Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.

Abstract

OBJECTIVE:

To examine the Institute of Medicine (IOM) guidelines for gestational weight gain (GWG) in insulin-resistant pregnancy.

STUDY DESIGN:

Secondary analysis of a prospective cohort of 435 women with type 2 or gestational diabetes from 2006 to 2010. The exposure was categorized as GWG less than, within or greater than the IOM recommendations for body mass index. The maternal outcome was a composite of preeclampsia, eclampsia, third- to fourth-degree laceration, readmission or wound infection. The neonatal outcome was a composite of preterm delivery, level 3 nursery admission, oxygen requirement >6 h, shoulder dystocia, 5-min Apgar3, umbilical cord arterial pH<7.1 or base excess <-12. Secondary outcomes were cesarean delivery (CD), macrosomia and small for gestational age (SGA).

RESULT:

Incidence of the maternal outcome did not differ with GWG (P=0.15). Women gaining more than recommended had an increased risk of CD (relative risk (RR) 1.31, 95% confidence interval (CI) 1.01 to 1.69) and the neonatal outcome (RR 1.40, 95% CI 1.01 to 1.95) compared with women gaining within the IOM recommendations. Women gaining less than recommended had an increased risk of SGA (RR 3.29, 95% CI 1.09 to 9.91) without a decrease in the risk of the maternal outcome (RR 0.93, 95% CI 0.49 to 1.78) or CD (RR 0.74, 95% CI 0.40 to 1.37) compared with women gaining within the IOM recommendations.

CONCLUSION:

Women with insulin resistance should be advised to gain within the current IOM guidelines.

PMID:
23949833
[PubMed - indexed for MEDLINE]
PMCID:
PMC3848869
Free PMC Article
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