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Arch Gynecol Obstet. 2011 Jul;284(1):235-40. doi: 10.1007/s00404-011-1917-7. Epub 2011 May 5.

Changes in prepregnancy body mass index between pregnancies and risk of gestational and type 2 diabetes.

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  • 1Department of Obstetrics and Gynecology, College of Medicine, University of South Florida, Tampa, FL, USA.



We investigated whether changes in interpregnancy body mass index (BMI) influence the risk of gestational and type 2 diabetes among a cohort of women with two consecutive live, singleton births of 20-44 weeks gestation (n = 232,272).


Logistic regression models were used to examine the risk for development of gestational or type 2 diabetes during the second pregnancy. Mothers with normal weight for both pregnancies (normal-normal) served as the referent group.


Across all BMI categories, mothers with significant weight gain (i.e., moving from a lower BMI category into a higher category) had an increased risk for the development of diabetes. Mothers who moved from normal prepregnancy weight (BMI = 18.5-24.9 kg/m²) in the first pregnancy to obese prepregnancy weight (BMI ≥ 30.0 kg/m²) in the second pregnancy showed the greatest increment in risk. These mothers exhibited a threefold risk for developing diabetes (OR = 3.21, 95% CI 2.76-3.73). Mothers who maintained their interpregnancy BMI weight category or who moved to a lower BMI category had reduced risk for gestational and type 2 diabetes. The risk associated with mothers who moved to a lower BMI category was approximately half that of the normal-normal BMI category.


Interpregnancy weight gain is associated with a dose-response increase in risk of diabetes. Establishing a normal interpregnancy BMI may reduce the risk of diabetes.

[PubMed - indexed for MEDLINE]
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