Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes

Background: Pregestational excessive body mass index (BMI) is linked to an increased risk for gestational diabetes mellitus (GDM), but less is known on the effect of adolescent BMI on GDM occurrence. The study aimed to investigate possible associations of adolescent BMI and changes in BMI experience...

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Autores principales:	Gabriel Chodick, Maayan Omer-Gilon, Estela Derazne, Gal Puris, Ran Rotem, Dorit Tzur, Orit Pinhas-Hamiel, Tali Cukierman-Yaffe, Avi Shina, Inbar Zucker, Amir Tirosh, Arnon Afek, Varda Shalev, Gilad Twig
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	gestational diabetes GDM BMI Adolescent pregnancy Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/7fe3a86da8344ada99f358855b3aca12
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spelling	oai:doaj.org-article:7fe3a86da8344ada99f358855b3aca122021-11-22T04:29:10ZAdolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes2589-537010.1016/j.eclinm.2021.101211https://doaj.org/article/7fe3a86da8344ada99f358855b3aca122021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2589537021004922https://doaj.org/toc/2589-5370Background: Pregestational excessive body mass index (BMI) is linked to an increased risk for gestational diabetes mellitus (GDM), but less is known on the effect of adolescent BMI on GDM occurrence. The study aimed to investigate possible associations of adolescent BMI and changes in BMI experienced before first pregnancy, with gestational diabetes risk. Methods: This retrospective study was based on linkage of a military screening database of adolescent health status (Israel Defence Forces) including measured height and weight, with medical records (Maccabi Healthcare Services, MHS) of a state-mandated health provider. The latter covers about 25% of the Israeli population; about 90% of pregnant women undergo screening by the two-step Carpenter-Coustan method. Adolescent BMI was categorized according to Center of Disease Control and Prevention percentiles. Only first documented pregnanies were analyzed and GDM was the outcome. Findings: Of 190,905 nulliparous women, 10,265 (5.4%) developed GDM. Incidence proportions of GDM were 5.1%, 6.1%, 7.3%, and 8.9% among women with adolescent normal BMI, underweight, overweight, and obesity (p<0.001), respectively. In models that accounted for age at pregnancy, birth year, and sociodemographic variables, the adjusted odd ratios (aORs) for developing GDM were: 1.2 (95%CI, 1.1-1.3), 1.5 (1.4-1.6), and 1.9 (1.7-2.1) for adolescent underweight, overweight, and obesity (reference group, normal BMI). Adolescent BMI tracked with BMI notes in the pre-pregnancy period (r=63%). Resuming normal pre-pregnancy BMI from overweight or obesity in adolescence diminished GDM risk, but this diminished risk was not observed among those who returned to a normal per-pre-pregnancy BMI from being underweight in adolescence. Sustained overweight or obesity conferred an aOR for developing GDM of 2.5 (2.2-2.7); weight gain from adolescent underweight and normal BMI to pre-pregnancy excessive BMI conferred aORs of 3.1 (1.6-6.2) and 2.6 (2.2-2.7), respectively. Interpretation: Change in BMI status from adolescence to pre-pregnancy may contribute to GDM risk. Identifying at-risk populations is important for early preventive interventions. Funding: None.Gabriel ChodickMaayan Omer-GilonEstela DerazneGal PurisRan RotemDorit TzurOrit Pinhas-HamielTali Cukierman-YaffeAvi ShinaInbar ZuckerAmir TiroshArnon AfekVarda ShalevGilad TwigElsevierarticlegestationaldiabetesGDMBMIAdolescentpregnancyMedicine (General)R5-920ENEClinicalMedicine, Vol 42, Iss , Pp 101211- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	gestational diabetes GDM BMI Adolescent pregnancy Medicine (General) R5-920
spellingShingle	gestational diabetes GDM BMI Adolescent pregnancy Medicine (General) R5-920 Gabriel Chodick Maayan Omer-Gilon Estela Derazne Gal Puris Ran Rotem Dorit Tzur Orit Pinhas-Hamiel Tali Cukierman-Yaffe Avi Shina Inbar Zucker Amir Tirosh Arnon Afek Varda Shalev Gilad Twig Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes
description	Background: Pregestational excessive body mass index (BMI) is linked to an increased risk for gestational diabetes mellitus (GDM), but less is known on the effect of adolescent BMI on GDM occurrence. The study aimed to investigate possible associations of adolescent BMI and changes in BMI experienced before first pregnancy, with gestational diabetes risk. Methods: This retrospective study was based on linkage of a military screening database of adolescent health status (Israel Defence Forces) including measured height and weight, with medical records (Maccabi Healthcare Services, MHS) of a state-mandated health provider. The latter covers about 25% of the Israeli population; about 90% of pregnant women undergo screening by the two-step Carpenter-Coustan method. Adolescent BMI was categorized according to Center of Disease Control and Prevention percentiles. Only first documented pregnanies were analyzed and GDM was the outcome. Findings: Of 190,905 nulliparous women, 10,265 (5.4%) developed GDM. Incidence proportions of GDM were 5.1%, 6.1%, 7.3%, and 8.9% among women with adolescent normal BMI, underweight, overweight, and obesity (p<0.001), respectively. In models that accounted for age at pregnancy, birth year, and sociodemographic variables, the adjusted odd ratios (aORs) for developing GDM were: 1.2 (95%CI, 1.1-1.3), 1.5 (1.4-1.6), and 1.9 (1.7-2.1) for adolescent underweight, overweight, and obesity (reference group, normal BMI). Adolescent BMI tracked with BMI notes in the pre-pregnancy period (r=63%). Resuming normal pre-pregnancy BMI from overweight or obesity in adolescence diminished GDM risk, but this diminished risk was not observed among those who returned to a normal per-pre-pregnancy BMI from being underweight in adolescence. Sustained overweight or obesity conferred an aOR for developing GDM of 2.5 (2.2-2.7); weight gain from adolescent underweight and normal BMI to pre-pregnancy excessive BMI conferred aORs of 3.1 (1.6-6.2) and 2.6 (2.2-2.7), respectively. Interpretation: Change in BMI status from adolescence to pre-pregnancy may contribute to GDM risk. Identifying at-risk populations is important for early preventive interventions. Funding: None.
format	article
author	Gabriel Chodick Maayan Omer-Gilon Estela Derazne Gal Puris Ran Rotem Dorit Tzur Orit Pinhas-Hamiel Tali Cukierman-Yaffe Avi Shina Inbar Zucker Amir Tirosh Arnon Afek Varda Shalev Gilad Twig
author_facet	Gabriel Chodick Maayan Omer-Gilon Estela Derazne Gal Puris Ran Rotem Dorit Tzur Orit Pinhas-Hamiel Tali Cukierman-Yaffe Avi Shina Inbar Zucker Amir Tirosh Arnon Afek Varda Shalev Gilad Twig
author_sort	Gabriel Chodick
title	Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes
title_short	Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes
title_full	Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes
title_fullStr	Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes
title_full_unstemmed	Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes
title_sort	adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/7fe3a86da8344ada99f358855b3aca12
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Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes

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