Burden of obesity and excess weight gain in women with gestational diabetes in Canterbury - a review of maternal and neonatal outcomes.  — ASN Events
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Burden of obesity and excess weight gain in women with gestational diabetes in Canterbury - a review of maternal and neonatal outcomes.  (#66)

Ellen Wall 1 , Alisha Panambalana 1 , Rebecca Lai 1 , Shailja Tewari 1
  1. Sydney Local Health District, Canterbury

Background: in pregnant women in Australia the reported rates of overweight and obesity in 2020 were 27% and 22% respectively. Known consequences of obesity during pregnancy include (but are not limited to) gestational diabetes (GDM), pre-eclampsia, venous thromboembolism and increased rates of caesarean section and peripartum complications. The rates of neonatal morbidity and mortality are also significantly higher (eg. congenital abnormalities, stillbirth, foetal macrosomia).1   

Aim: assess burden of overweight and obesity in women diagnosed with GDM. Examine maternal, obstetric and neonatal consequences of excess gestational weight gain (eGWG) in women diagnosed with GDM. 

Method: retrospective data audit of treatments, maternal and neonatal outcomes for 53 women with GDM who experienced eGWG in pregnancy between October 2021-22. Patients with excess weight gain were identified based upon weight measurements at time of initial GDM diagnosis and review in the Canterbury Antenatal Clinic. Patients were assessed based upon the US Institute of Medicine recommendations for total gestational weight gain (pre-pregnancy BMI<18.5kg/m2: 12.5-18kg, BMI 18.5-24.9kg/m2: 11.5-16kg, BMI 25-29.9kg/m2: 7-11.5kg and BMI>30kg/m2: 5-9kg).2  

Results: most women who experienced eGWG were overweight/obese prior to pregnancy. Of the 362 identified GDM cases in the study period, 53 had eGWG (14.6%). The average weight gain at the time of GDM diagnosis was 17.4kg. Women who experienced eGWG were already overweight (26.4%) or obese (45.3%) prior to pregnancy and only 26.3% were in the healthy weight range pre-pregnancy. Fifty-seven percent of women with eGWG required insulin therapy. Forty-five percent required caesarean section delivery and rates of immediate post-partum neonatal complications (respiratory distress, hypoglycaemia, jaundice) was 19%.  

Conclusion: high rates of obesity compared with national average was noted in pregnant women in the Canterbury Hospital antenatal population. The obese and overweight women with GDM also experience eGWG during pregnancy.

 

 

 

 

  1. Australian Institute of Health and Welfare (AIHW). Australia's mothers and babies - body mass index. Last updated 14 Dec 2022. https://www.aihw.gov.au/reports/mothers-babies/australias-mothers-babies-data-visualisations/contents/antenatal-period/body-mass-index
  2. American College of Obstetricians and Gynaecologists (ACOG). Weight gain during pregnancy. Jan 2013. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/01/weight-gain-during-pregnancy#:~:text=The%20IOM%20guidelines%20recommend%20a,by%20height%20in%20meters%20squared).
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