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urn:hdl:2072/472441 Association between gestational weight gain, gestational diabetes risk, and obstetric outcomes : A randomized controlled trial post hoc analysis Simmons, David Devlieger, Roland van Assche, Andre Galjaard, Sander Corcoy i Pla, Rosa Adelantado, Juan M Dunne, Fidelma Desoye, Gernot Kautzky-Willer, Alexandra Damm, Peter Mathiesen, Elisabeth Reinhardt Jensen, Dorte M. Andersen, Lise-Lotte Lapolla, Annunziata Dalfra, Maria Grazia Bertolotto, Alessandra Wender-Ozegowska, Ewa Zawiejska, Agnieszka Hill, David Snoek, Frank J. Van Poppel, Mireille Universitat Autònoma de Barcelona Gestational diabetes mellitus Healthy eating Lifestyle intervention Motivational interviewing Overweight Physical activity Pregnancy Prevention Randomised controlled trial Excess gestational weight gain (GWG) is associated with the development of gestational diabetes mellitus (GDM). Lifestyle trials have not achieved much GWG limitation, and have largely failed to prevent GDM. We compared the effect of substantial GWG limitation on maternal GDM risk. Pregnant women with a body mass index (BMI) ≥29 kg/m <20 weeks gestation without GDM (n = 436) were randomized, in a multicenter trial, to usual care (UC), healthy eating (HE), physical activity (PA), or HE and PA lifestyle interventions. GWG over the median was associated with higher homeostasis model assessment insulin resistance (HOMA-IR) and insulin secretion (Stumvoll phases 1 and 2), a higher fasting plasma glucose (FPG) at 24-28 weeks (4.66 ± 0.43 vs. 4.61 ± 0.40 mmol/L, p < 0.01), and a higher rate of caesarean section (38% vs. 27% p < 0.05). The GWG over the median at 35-37 weeks was associated with a higher rate of macrosomia (25% vs. 16%, p < 0.05). A post hoc comparison among women from the five sites with a GWG difference >3 kg showed no significance difference in glycaemia or insulin resistance between HE and PA, and UC. We conclude that preventing even substantial increases in GWG after the first trimester has little effect on maternal glycaemia. We recommend randomized controlled trials of effective lifestyle interventions, starting in or before the first trimester. 2018 Article Nutrients ; Vol. 10 Núm. 11 (november 2018), p. 1568 open access Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. https://creativecommons.org/licenses/by/4.0/