Endocrine Abstracts

Background: The effect of maternal weight gain in obstetric and perinatal morbidity in pregnant with gestational diabetes (GD) is not established.

Objectives: Evaluation of the impact of weight gain in obstetric and perinatal outcomes in women with GD.

Methods: Retrospective study of women with GD between January/2020-March/2021. Weight gain in pregnancy was evaluated by 2009 IOM recommendations, women were divided in 3 groups: excessive weight gain (EWG), adequate weight gain (AWG) and insufficient weight gain (IWG).

Results: Included 63 women (mean age 34.22±35 years; 39.7% with 1st trimester(T) and 39.7% with 2nd T GD). There was AWG in 23.8%, IWG in 36.5% and EWG in 39.7%. In IWG group, women’ mean weight gain in pregnancy was 4.59±3.71g and the mean HbA1C in 3^rd T was 5.29±0.26%. These women were treated for DG with: diet (10), insulin (1), metformin (9) and with metformin + insulin (3). Within AWG group, the mean weight gain in pregnancy was 10,95±2.31g and the mean HbA1C in the 3^rd T was 5.45±0.38%. DG treatment options in this group were: diet (9), metformin (5) and metformin + insulin (1). Regarding EWG group, the mean weight gain was 13.9±4.56g and the mean HbA1C in 3^rd T was 5.46±0.40%. Considering perinatal outcomes, all macrosomic babies (n=4) were born from women with EWG (P=0.045). There were 5 large for gestational age (LGA) babies (4 from EWG and 1 from AWG mothers) and 1 small for gestational age (SGA) (from an IWG mother - P=0.049). The majority of babies with neonatal jaundice and hypoglycaemia were born from mothers with IWG. Regarding obstetric outcomes, EWG women had higher odds of caesarean section [OR=2.1 95CI(0.46-9.64)]. Preterm delivery rates were similar in all groups (P=0.4), however AWG group had more full-term deliveries.

Conclusions: In pregnant with GD, EWG was associated with more cases of macrosomic and LGA babies and caesarean section. AWG appear to be related with full-term deliveries and EWG with higher mean values of HbA1C.