1255-P: Association of Gestational Diabetes with Maternal Weight Change in the Two Years prior to Pregnancy

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Introduction and Objective: Although achieving a healthy weight prior to pregnancy is recommended, data on the association between preconception weight changes and pregnancy outcomes are limited. We examined the relationship between preconception weight trajectories and risk of GDM in a large, diverse cohort.Methods: We conducted a retrospective cohort study of 257,017 pregnancies resulting in singleton, live birth at ≥28.0 weeks gestation for whom GDM screening was completed within 4 health care systems. Eligible pregnancies had ≥2 weight measurements in the electronic medical record in the 2 years prior to pregnancy with at least one in each of these periods: 0-12 months and 13-24 months prior to pregnancy onset. Preconception weight change rate was estimated using linear mixed effects trajectory models. GDM diagnosis was determined based on glucose levels from oral glucose tolerance testing. We modeled GDM as a function of preconception weight change, BMI category at the start of the preconception period (<25, 25-<30, ≥30 kg/m2) and covariates (maternal age, race and ethnicity, parity, insurance status, health care system) using a multilevel Poisson model with robust standard errors to estimate relative risk and absolute risk, accounting for multiple pregnancies within women.Results: Of included pregnancies, 62% were parous; 45% were Hispanic, 30% non-Hispanic White, 9% non-Hispanic Black, and 17% other races; and 11.7% had diagnosed GDM. Mean preconception BMI was 27 kg/m2 and 27% had a BMI≥30. Mean rate of weight change in the 2 years prior to pregnancy was +0.44 kg/yr (SD=3.73). Every kg/yr of increased weight was associated with 4.8% greater risk of GDM (RR=1.048, 95% CI [1.044, 1.052]). Adjusted risk of GDM was lower among those who lost weight prior to pregnancy compared to those who gained weight (9% risk of GDM for 5 kg/year loss vs 14.5% for 5 kg/yr gain).Conclusion: In this diverse, U.S. cohort, preconception weight change was positively associated with GDM risk.

Disclosure

K.K. Vesco: None. E.S. LeBlanc: None. C.E. Oshiro: None. M. Lee: None. M.C. Leo: Research Support; PreludeDx. M. Mayhew: None. D.R. Young: None. C. McCracken: None. A. Owen-Smith: None. N.A. Rosenquist: None. J. Boone-Heinonen: None.

Funding

Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD102477)



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