ATLANTIC-DIP: Excessive Gestational Weight Gain and Pregnancy Outcomes in Women With Gestational or Pregestational Diabetes Mellitus
Open accessAbstract
CONTEXT: Women who have diabetes mellitus during pregnancy are at higher risk of adverse outcomes. Excessive gestational weight gain (GWG) is also emerging as a risk factor for maternofetal complications, and in 2009, the Institute of Medicine published recommendations for appropriate GWG. It is unclear whether excessive GWG confers additional risk to women with diabetes in pregnancy and whether Institute of Medicine recommendations are applicable to this population. OBJECTIVE: The objective of this study was to examine whether excessive GWG in pregnancies complicated by diabetes mellitus is associated with higher adverse obstetric outcomes. DESIGN: This was an observational study. SETTING: The study was conducted at five antenatal centers along the Irish Atlantic seaboard. PARTICIPANTS: 802 women with diabetes in pregnancy participated in the study. MAIN OUTCOME MEASURE: Maternal outcomes examined included preeclampsia, gestational hypertension, and cesarean delivery. Fetal outcomes included large for gestational age (LGA), macrosomia, and small for gestational age. RESULTS: Excessive GWG was noted in 59% of women. In all women, excessive GWG resulted in higher odds for LGA [adjusted odds ratio (aOR) 2.01, 95% confidence intervals 1.24-3.25 in GDM; aOR 3.97, CI 1.85-8.53 in pregestational diabetes mellitus (PGDM)] and macrosomia (aOR 2.17, CI 1.32-3.55 in GDM; aOR 3.58, CI 1.77-7.24 in PGDM). Excessive GWG was also associated with an increased odds for gestational hypertension (aOR 1.72, CI 1.04-2.85) in women with GDM, and treatment with insulin further increased the odds for LGA (aOR 2.80, CI 1.23-6.38) and macrosomia (aOR 5.63, CI 2.16-14.69) in this group. CONCLUSION: We show that in the already high-risk settings of both GDM and PGDM, excessive GWG confers an additive risk for LGA birth weight, macrosomia, and gestational hypertension.
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Cites
Hyperglycemia and adverse pregnancy outcomes
(2008) · New England Journal of Medicine · doi:10.1056/nejmoa0707943 · Cited by 5,563 · see citing works
International Association of Diabetes and Pregnancy Study Groups Consensus Panel (2010) · Diabetes Care · doi:10.2337/dc09-1848 · Cited by 5,390 · see citing works
Weight Gain During Pregnancy: Reexamining the Guidelines
Rasmussen, K. M., & Yaktine, A. L. (2009) · Cited by 4,052 · see citing works
Metformin versus insulin for the treatment of gestational diabetes
Rowan, J. A., Hague, W. M., Gao, W., Battin, M. R., & Moore, M. P. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0707193 · Cited by 1,291 · see citing works
Thangaratinam, S., Rogozinska, E., Jolly, K., Glinkowski, S., Roseboom, T., Tomlinson, J. W., Kunz, R., Mol, B. W., Coomarasamy, A., & Khan, K. S. (2012) · BMJ · doi:10.1136/bmj.e2088 · Cited by 802 · see citing works
Nohr, E. A., Væth, M., Baker, J. L., Sørensen, T. I. A., Olsen, J., & Rasmussen, K. M. (2008) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/87.6.1750 · Cited by 649 · see citing works
The macrosomic fetus: a challenge in current obstetrics
Henriksen, T. (2008) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1080/00016340801899289 · Cited by 458 · see citing works
Metformin in Gestational Diabetes: The Offspring Follow-Up (MiG TOFU)
Rowan, J. A., Rush, E. C., Obolonkin, V., Battin, M., Wouldes, T., & Hague, W. M. (2011) · Diabetes Care · doi:10.2337/dc11-0660 · Cited by 379 · see citing works
Koyanagi, A., Zhang, J., Dagvadorj, A., Hirayama, F., Shibuya, K., Souza, J. P., & Gülmezoglu, A. M. (2013) · The Lancet · doi:10.1016/s0140-6736(12)61605-5 · Cited by 366 · see citing works
Oteng-Ntim, E., Varma, R., Croker, H., Poston, L., & Doyle, P. (2012) · BMC Medicine · doi:10.1186/1741-7015-10-47 · Cited by 352 · see citing works
Black, M. H., Sacks, D. A., Xiang, A. H., & Lawrence, J. M. (2012) · Diabetes Care · doi:10.2337/dc12-0741 · Cited by 326 · see citing works
The association between pregnancy weight gain and birthweight: a within-family comparison
Ludwig, D. S., & Currie, J. L. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60751-9 · Cited by 321 · see citing works
Mamun, A. A., O'Callaghan, M. J., Callaway, L. K., Williams, G. M., Najman, J. M., & Lawlor, D. A. (2009) · Circulation · doi:10.1161/circulationaha.108.813436 · Cited by 312 · see citing works
collaborators, O. B. O. T. A. D., O’Sullivan, E. P., Avalos, G., O’Reilly, M., Dennedy, M. C., Gaffney, G., & Dunne, F. (2011) · Diabetologia · doi:10.1007/s00125-011-2150-4 · Cited by 307 · see citing works
Self-citationChu, S. Y., Callaghan, W. M., Bish, C. L., & D’Angelo, D. V. (2009) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2008.09.879 · Cited by 292 · see citing works
Population pharmacokinetics of metformin in late pregnancy
Charles, B., Norris, R., Xiao, X., & Hague, W. (2006) · Therapeutic Drug Monitoring · doi:10.1097/01.ftd.0000184161.52573.0e · Cited by 212 · see citing works
Mamun, A. A., Callaway, L. K., O'Callaghan, M. J., Williams, G. M., Najman, J. M., Alati, R., Clavarino, A. M., & Lawlor, D. A. (2011) · BMC Pregnancy and Childbirth · doi:10.1186/1471-2393-11-62 · Cited by 210 · see citing works
Oostdam, N., van Poppel, M. N. M., Wouters, M. G. A. J., Eekhoff, E. M. W., Bekedam, D., Kuchenbecker, W., Quartero, H. W. P., Heres, M., & van Mechelen, W. (2012) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2012.03366.x · Cited by 176 · see citing works
ATLANTIC DIP: The Impact of Obesity on Pregnancy Outcome in Glucose-Tolerant Women
Owens, L. A., O’Sullivan, E. P., Kirwan, B., Avalos, G., Gaffney, G., Dunne, F., & Collaborators, F. T. A. D. (2010) · Diabetes Care · doi:10.2337/dc09-0911 · Cited by 145 · see citing works
Self-citationMaternal weight and body composition in the first trimester of pregnancy
Fattah, C., Farah, N., Barry, S. C., O’Connor, N., Stuart, B., & Turner, M. J. (2010) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.3109/00016341003801706 · Cited by 144 · see citing works
Insulin Glargine Safety in Pregnancy
Pollex, E. K., Feig, D. S., Lubetsky, A., Yip, P. M., & Koren, G. (2010) · Diabetes Care · doi:10.2337/dc09-1045 · Cited by 104 · see citing works
Desoyé, G., Hofmann, H. H., & Weiss, P. (1992) · Diabetologia · doi:10.1007/bf00400851 · Cited by 93 · see citing works
The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome
Dennedy, M. C., & Dunne, F. (2010) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2010.06.001 · Cited by 89 · see citing works
Self-citationMetformin's Effect on First-Year Weight Gain: A Follow-up Study
Carlsen, S. M., Martinussen, M., & Vanky, E. (2012) · PEDIATRICS · doi:10.1542/peds.2012-0346 · Cited by 81 · see citing works
Dunne, F., Avalos, G., Durkan, M., Mitchell, Y., Gallacher, T., Keenan, M., Hogan, M., Carmody, L. A., Gaffney, G., & collaborators, F. T. A. D. (2009) · Diabetes Care · doi:10.2337/dc09-1118 · Cited by 70 · see citing works
Self-citationDennedy, M. C., Avalos, G., O’Reilly, M., O'Sullivan, E. P., Gaffney, G., & Dunne, F. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-2674 · Cited by 63 · see citing works
Self-citationYee, L. M., Cheng, Y. W., Inturrisi, M., & Caughey, A. B. (2011) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2011.06.028 · Cited by 54 · see citing works
Barrett, H. L., Nitert, M. D., Jones, L. V., O'Rourke, P. K., Lust, K. M. C., Gatford, K. L., Blasio, M. J. D., Coat, S., Owens, J. A., Hague, W. M., et al. (2013) · Diabetes Care · doi:10.2337/dc12-2132 · Cited by 28 · see citing works
Insulin-anti-insulin complexes in diabetic women and their neonates
Mario, U. D., Fallucca, F., Gargiulo, P., Tiberti, C., Scardellato, A., Arduini, P., Pachı̀, A., & Andreani, D. (1984) · Diabetologia · doi:10.1007/bf00275654 · Cited by 27 · see citing works
Kinnunen, T. I., Raitanen, J. A., Aittasalo, M., et al. (2012) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2012.146 · Cited by 18 · see citing works
ATLANTIC DIP: pregnancy outcomes for women with type 1 and type 2 diabetes.
Dunne, F. P., Avalos, G., Durkan, M., et al. (2012) · PubMed · Cited by 13 · see citing works
Self-citationThe birth of ATLANTIC DIP: an overview.
Doolan, A., Cousins, J., & Sheridan‐Pereira, M. (2012) · PubMed · Cited by 7 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- [8]8. Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines. In: Rasmussen KM, Yaktine AL, ed. Weight Gain During Pregnancy: ReexaminingtheGuidelines. Washington,DC:NationalAcadamies Press (US); 2009.
- [14]14. Dennedy MC, Avalos G, O'Reilly MW, O'Sullivan EP, Gaffney G, Dunne F. ATLANTIC-DIP: raised maternal body mass index (BMI) adversely affects maternal and fetal outcomes in glucose-tolerant womenaccordingtoInternationalAssociationofDiabetesandPregnancy Study Groups (IADPSG) criteria. J Clin Endocrinol Metab . 2012;97:E608-E612.
Cited by
Sorted by citations
Gestational Diabetes Mellitus and Preeclampsia: Correlation and Influencing Factors
Yang, Y., & Wu, N. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.831297 · Cited by 155 · see citing works
Spaight, C., Gross, J., Horsch, A., & Puder, J. J. (2016) · Endocrine Development · doi:10.1159/000439413 · Cited by 148 · see citing works
Li, C., Liu, Y., & Zhang, W. (2015) · PLOS ONE · doi:10.1371/journal.pone.0136850 · Cited by 125 · see citing works
Miao, M., Dai, M., Zhang, Y., Sun, F., Guo, X., & Sun, G. (2017) · Scientific Reports · doi:10.1038/s41598-017-00441-z · Cited by 107 · see citing works
Weight gain adequacy and pregnancy outcomes in gestational diabetes: a meta‐analysis
Viecceli, C., Remonti, L. R., Hirakata, V. N., Mastella, L. S., Gnielka, V., Oppermann, M. L. R., Silveiro, S. P., & Reichelt, A. J. (2017) · Obesity Reviews · doi:10.1111/obr.12521 · Cited by 90 · see citing works
Durnwald, C. (2015) · Seminars in Perinatology · doi:10.1053/j.semperi.2015.05.002 · Cited by 85 · see citing works
Barnes, R. A., Wong, T., Ross, G. P., Griffiths, M. M., Smart, C. E., Collins, C. E., MacDonald-Wicks, L., & Flack, J. R. (2020) · Diabetes Care · doi:10.2337/dc19-0800 · Cited by 80 · see citing works
Shi, P., Liu, A., & Yin, X. (2021) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-021-03982-4 · Cited by 49 · see citing works
Impact of gestational weight gain on obstetric and neonatal outcomes in obese diabetic women
Gante, I., Amaral, N., Dores, J., & Almeida, M. C. (2015) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-015-0692-z · Cited by 49 · see citing works
Ke, J.-F., Liu, S., Ge, R.-L., Ma, L., & Li, M.-F. (2023) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-023-05657-8 · Cited by 50 · see citing works
Blackwell, S. C., Landon, M. B., Mele, L., Reddy, U. M., Casey, B. M., Wapner, R. J., Varner, M. W., Rouse, D. J., Thorp, J. M., Sciscione, A., et al. (2016) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000001773 · Cited by 33 · see citing works
Gestational weight gain and weight loss among women with gestational diabetes mellitus
Komem, D., Salman, L., Krispin, E., Arbib, N., Bardin, R., Wiznitzer, A., & Hadar, E. (2018) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2018.04.034 · Cited by 21 · see citing works
- Authors
- Egan, A. M., Dennedy, M. C., Al-Ramli, W., Heerey, A., Avalos, G., & Dunne, F.
- Affiliations
- Ollscoil na Gaillimhe – University of Galway (IE)
- Corresponding author
- Egan, Aoife M.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2014-01
- Volume
- 99
- Issue
- 1
- Pages
- 212-219
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W1967841511
- Semantic Scholar
- 6971e0b1c020b652c56708809790bf6357cbcc0f
- Cited by
- 125
- References
- 32
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 1 · 2023: 8 · 2022: 17 · 2021: 12 · 2020: 10 · 2019: 13 · 2018: 16 · 2017: 9 · 2016: 10 · 2015: 15 · 2014: 6
- FWCI
- 11.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- ARAN (University of Galway Research Repository) (Ollscoil na Gaillimhe – University of Galway) (acceptedVersion, cc-by-nc-nd)
- Arrow@dit (Dublin Institute of Technology) (submittedVersion)
- ARAN (University of Galway Research Repository) (Ollscoil na Gaillimhe – University of Galway) (submittedVersion, cc-by-nc-nd)
- ARAN (University of Galway Research Repository) (Ollscoil na Gaillimhe – University of Galway) (submittedVersion, cc-by-nc)
- Research Repository UCD (University College Dublin) (cc-by-nc)
- Funders
- National University of Ireland
- Health Research Board
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- excessive gestational weight gain, gestational diabetes mellitus, pregestational diabetes, pregnancy outcomes, large for gestational age, macrosomia, gestational hypertension, preeclampsia, cesarean section, small for gestational age, insulin therapy, Institute of Medicine weight gain recommendations
- MeSH terms
- Adult, Atlantic Ocean, Female, Humans, Ireland, Prediabetic State, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Weight Gain, Body Mass Index, Diabetes, Gestational, Overweight
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