Characterizing Gestational Weight Gain According to Institute of Medicine Guidelines in Women with Type 1 Diabetes Mellitus: Association with Maternal and Perinatal Outcome

Am J Perinatol. 2016 Nov;33(13):1266-1272. doi: 10.1055/s-0036-1585420. Epub 2016 Jul 11.


Objective This study aims to evaluate the association between gestational weight gain (GWG) defined by the current Institute of Medicine (IOM) guidelines and pregnancy outcomes in women with type 1 diabetes mellitus (DM). Study design This is a secondary analysis of a cohort of 293 pregnancies of women with type 1 DM between 24 and 41 weeks' gestation. Women were categorized according to GWG per week over the second and third trimester: below, within, and above the IOM guidelines. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated for maternal and neonatal outcomes, controlling for covariates and confounders (referent: GWG within the IOM guidelines). Results Of the 293 women, there were 49 women (16.7%) with the GWG below the IOM guidelines, 86 women (29.4%) with the GWG within the IOM guidelines, and 158 women (53.9%) with the GWG above the IOM guidelines. Women with the GWG above the IOM guidelines had a higher risk of macrosomia and neonatal hyperbilirubinemia (aOR: 2.78; 95% CI: 1.23-6.30 and 2.31; 1.22-4.35, respectively). Conclusion GWG above the IOM guidelines is associated with an increased risk of macrosomia and neonatal hyperbilirubinemia. Maintaining GWG within the IOM guidelines may decrease the risk of excessive fetal growth and neonatal hyperbilirubinemia in infants of women with type 1 DM.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cesarean Section / statistics & numerical data
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Female
  • Fetal Macrosomia / etiology
  • Humans
  • Hyperbilirubinemia, Neonatal / etiology
  • Hypoglycemic Agents / administration & dosage
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Insulin / administration & dosage
  • Labor, Induced / statistics & numerical data
  • National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division
  • Polycythemia / etiology
  • Practice Guidelines as Topic
  • Pre-Eclampsia / etiology
  • Pregnancy
  • Pregnancy Trimester, Second
  • Pregnancy Trimester, Third
  • Pregnancy in Diabetics / drug therapy
  • Pregnancy in Diabetics / physiopathology*
  • Prospective Studies
  • United States
  • Weight Gain*
  • Young Adult


  • Hypoglycemic Agents
  • Insulin