Gestational Weight Gain and Risk of Gestational Diabetes Mellitus
Open accessAbstract
OBJECTIVE: To estimate the relationship between the rate of gestational weight gain before the 50-g, 1-hour oral glucose challenge test screening for gestational diabetes mellitus (GDM) and subsequent risk of GDM. METHODS: We conducted a nested case-control study (345 women with GDM and 800 women in the control group) within a multiethnic cohort of women delivering between 1996 and 1998 who were screened for GDM at 24-28 weeks of gestation. GDM was diagnosed according to the National Diabetes Data Group plasma glucose cut-offs for the 100-g, 3-hour oral glucose tolerance test. Women's plasma glucose levels, weights, and covariate data were obtained by medical record chart review. RESULTS: After adjusting for age at delivery, race/ethnicity, parity, and prepregnancy body mass index, the risk of GDM increased with increasing rates of gestational weight gain. Compared with the lowest tertile of rate of gestational weight gain (less than 0.27 kg/week [less than 0.60 lb/wk]), a rate of weight gain from 0.27-0.40 kg/wk (0.60-0.88 lb/wk) and 0.41 kg/wk (0.89 lb/wk) or more, were associated with increased risks of GDM (odds ratio 1.43, 95% confidence interval 0.96-2.14; and odds ratio 1.74, 95% confidence interval 1.16-2.60, respectively). The association between the rate of gestational weight gain and GDM was primarily attributed to increased weight gain in the first trimester. The association was stronger in overweight [corrected] and nonwhite women. CONCLUSION: High rates of gestational weight gain, especially early in pregnancy, may increase a woman's risk of GDM. Gestational weight gain during early pregnancy may represent a modifiable risk factor for GDM and needs more attention from health care providers.
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Early GWG (0.27 to 0.40 kg/week) is associated with an elevated risk of GDM (OR 1.43-1.74), driven by maternal fat accumulation and reduced insulin sensitivity in early pregnancy.
“Early GWG (0.27 to 0.40 kg/week) is associated with an elevated risk of GDM (OR 1.43–1.74) [38], driven by maternal fat accumulation [38] and reduced insulin sensitivity [39] in early pregnancy.”
From Medical Nutrition Therapy for Women with Gestational Diabetes: Current Practice and Future Perspectives (2025) · cites this paper as [38]
The Abstract Results report ORs of 1.43 for 0.27–0.40 kg/week and 1.74 for at least 0.41 kg/week, with the association primarily attributable to first-trimester weight gain. The Discussion proposes maternal fat accumulation as a possible mechanism, but says the study did not measure the components of weight gain; it does not establish that fat accumulation drove the association. The reduced-insulin-sensitivity clause is cited to a different source [39]. (LLM, conf=0.88)
Experimental — accuracy not yet measuredExceeding a certain level of metabolic disorders resulting in GDM does not require an increase in adipose tissue mass.
“experimental studies found that exceeding a certain level of metabolic disorders resulting in GDM does not require increase in the adipose tissue mass [23–25].”
From Associations of maternal pre-pregnancy BMI and gestational weight gain with the risks of adverse pregnancy outcomes in Chinese women with gestational diabetes mellitus (2023) · cites this paper as [23]
The Methods describe a nested case–control study, not an experiment. The Discussion says the authors did not measure the composition of gestational weight gain, including maternal fat mass. Our copy therefore cannot establish whether GDM can develop without an increase in adipose tissue mass. (LLM, conf=0.76)
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- Authors
- Hedderson, M. M., Gunderson, E. P., & Ferrara, A.
- Affiliations
- Kaiser Permanente (US)
- Venue
- Obstetrics & Gynecology
- Published
- 2010-03
- Volume
- 115
- Issue
- 3
- Pages
- 597-604
- ISSN
- 0029-7844 (ISSN-L)
- PMC
- PMC3180899
- OpenAlex
- W2081003443
- Semantic Scholar
- b34b6d0fb83bf448d8692388b96ca15d69634a2e
- Cited by
- 568
- References
- 25
- Citations by year
- 2026: 19 · 2025: 18 · 2024: 27 · 2023: 49 · 2022: 40 · 2021: 39 · 2020: 45 · 2019: 44 · 2018: 35 · 2017: 41 · 2016: 45 · 2015: 46 · 2014: 35 · 2013: 22 · 2012: 32
- FWCI
- 36.64
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK54834, R01DK054834)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- gestational weight gain, gestational diabetes mellitus, oral glucose tolerance test, oral glucose challenge test, risk factors, overweight women, racial and ethnic differences, pre-pregnancy body mass index
- MeSH terms
- Adolescent, Adult, Female, Glucose Tolerance Test, Humans, Middle Aged, Pregnancy, Pregnancy Trimester, First, Pregnancy Trimester, Second, Prenatal Diagnosis, Risk Factors, Weight Gain, Case-Control Studies, Diabetes, Gestational, Young Adult
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