Gestational Weight Gain and Risk of Gestational Diabetes and Preterm Delivery
Grantee: Kaiser Foundation Hospitals
Principal Investigator: Monique Hedderson
Project Number: R40MC21515
Project Date: 2/1/2011
Age group(s)
- Women/Maternal
- Prenatal
Abstract
Background: Determining the appropriate amount of gestational weight gain (GWG) is essential given that it has important long-term implications for both maternal and child health. Due to the nationwide obesity epidemic the number of women who enter pregnancy obese is at an all-time high. New 2009 Institute of Medicine (IOM) recommendations for gestational weight gain were recently released and need to be validated against perinatal complications. Two perinatal complications of interest that the IOM highlighted as needing further study in relation to GWG are gestational diabetes mellitus (GDM) and preterm delivery (PTD). Previous studies of GWG and GDM have been limited by small numbers of cases of GDM or did not take into account the temporality of the GDM diagnosis. Studies of gestational weight gain and PTD were limited by small numbers or have failed to evaluate preterm birth sub-types which may have significant etiologic differences. We propose to conduct a cohort study with a retrospective and prospective component, among an estimated 11,000 multi-ethnic Kaiser Permanente Northern California health plan members who completed a detailed survey in 2007 and had or will have a subsequent live birth delivered up to 2012. For the 2,000 estimated pregnancies occurring in 2011-2012 women will be mailed questionnaires during pregnancy to further assess the roles of diet, physical activity and psychosocial factors during pregnancy on gestational weight gain and outcomes of interest. Specific Aims: 1) To evaluate whether increasing rate of gestational weight gain up to the time of screening for GDM is associated with an increased risk of GDM, independently of pregravid: age, race-ethnicity, reproductive history, body mass index, diet, physical activity, alcohol consumption and smoking. 2) To examine rate of gestational weight gain and the risk of preterm birth sub-types: spontaneous preterm birth, and medically indicated preterm birth, independently of the aforementioned covariates. 3) To examine effect modification by maternal obesity and race/ethnicity in the associations of gestational weight gain and risk of GDM and the PTD sub-types. 4) To examine whether the associations between gestational weight gain and GDM and PTD are independent of diet and physical activity during pregnancy. 5) To examine the relationship between lifestyle factors (diet and physical activity) both before and during pregnancy and excessive gestational weight gain. These findings will provide valuable information to increase our understanding of gestational weight gain and two important perinatal complications. Findings may also inform the identification of strategies to improve maternal gestational weight gain and be used for future health promotion planning models. In addition, findings from this study could provide new modifiable risk factors that would have important implications for the development of prevention strategies for both GDM and PTD. This proposal addresses goals of MCHB's Strategic Plan FYs 2004-2009 Research Issues #2 and #4 that include foci on health disparities and the healthy development of maternal and child health populations and addresses key Healthy People 2010 objectives: 1. Increase the proportion of mothers who achieve a recommended weight gain during their pregnancies. (Objective 16-12). 2. Decrease the proportion of pregnant women with gestational diabetes. (Objective 05-08) 3. Reduce preterm births (Objective 16-11).Publications
Listed is descending order by year published.
Sridhar SB, Darbinian J, Ehrlich SF, Markman MA, Gunderson EP, Ferrara A, Hedderson MM. Maternal gestational weight gain and offspring risk for childhood overweight or obesity. Am J Obstet Gynecol. 2014 Sep;211(3):259.e1-8.
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