Predictors and consequences of weight retention in the early and late postpartum period in women with gestational diabetes

Dan Yedu Quansah; Justine Gross; Leah Gilbert; Amar Arhab; Antje Horsch; Jardena J Puder

doi:10.1016/j.diabres.2020.108238

Predictors and consequences of weight retention in the early and late postpartum period in women with gestational diabetes

Diabetes Res Clin Pract. 2020 Jul:165:108238. doi: 10.1016/j.diabres.2020.108238. Epub 2020 Jun 2.

Authors

Dan Yedu Quansah¹, Justine Gross², Leah Gilbert³, Amar Arhab⁴, Antje Horsch⁵, Jardena J Puder⁶

Affiliations

¹ Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: dan.quansah@chuv.ch.
² Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland; Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: Justine.Gross@chuv.ch.
³ Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: Leah.Gilbert@chuv.ch.
⁴ Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: Amar.Arhab@chuv.ch.
⁵ Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Switzerland; Neonatology Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: Antje.Horsch@chuv.ch.
⁶ Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: Jardena.puder@chuv.ch.

PMID: 32502690
DOI: 10.1016/j.diabres.2020.108238

Abstract

Aims: To assist preventive strategies, we investigated the predictors and consequences of postpartum weight retention (PPWR) in the early and late postpartum period in women with gestational diabetes (GDM).

Methods: 862 women with GDM between 2011 and 2019 were prospectively included. We investigated PPWR at 6-8 weeks (n = 862) and at 1-year (n = 259) postpartum. Potential predictors included gestational weight gain (GWG), weight, BMI, and glucose control parameters during and after pregnancy.

Results: Mean PPWR at 6-8 weeks and 1-year postpartum were 4.6 ± 5.7 kg and 4.0 ± 7.4 kg. The proportion of women with PPWR at 6-8 weeks and at 1-year postpartum were 81% and 66.4% respectively. At 6-8 weeks postpartum, women with PPWR had higher pre-pregnancy weight, 7.5 ± 0.2 kg higher GWG and higher postpartum weight (all p ≤ 0.02), without presenting metabolic differences. At 1-year postpartum, there were no differences in anthropometric parameters before and during pregnancy between women with or without PPWR, except for a 4 ± 0.4 kg higher GWG (p < 0.001). However, women with PPWR had increased postpartum weight and BMI, higher fasting glucose and more pronounced increase in Δfasting glucose and ΔHbA1c at 1-year postpartum (all p ≤ 0.03). GWG predicted higher PPWR at both 6-8 weeks and at 1-year postpartum (all p < 0.001).

Conclusion: Women with PPWR had increased anthropometric parameters and adverse metabolic consequences at 1-year postpartum. GWG was the most relevant predictor of PPWR.

Keywords: Anthropometric; Gestational diabetes mellitus; Gestational weight gain; Metabolic consequences; Postpartum weight retention; Predictors.

MeSH terms

Adult
Body Mass Index*
Diabetes, Gestational / physiopathology*
Female
Gestational Weight Gain / physiology*
Humans
Postpartum Period
Pregnancy
Prospective Studies