2026-04-13T01:03:20Zhttps://recercat.cat/oai/request

oai:recercat.cat:2072/4724412024-12-11T07:05:18Zcom_2072_98col_2072_378192

00925njm 22002777a 4500 dc Simmons, David author Devlieger, Roland author van Assche, Andre author Galjaard, Sander author Corcoy i Pla, Rosa author Adelantado, Juan M author Dunne, Fidelma author Desoye, Gernot author Kautzky-Willer, Alexandra author Damm, Peter author Mathiesen, Elisabeth Reinhardt author Jensen, Dorte M. author Andersen, Lise-Lotte author Lapolla, Annunziata author Dalfra, Maria Grazia author Bertolotto, Alessandra author Wender-Ozegowska, Ewa author Zawiejska, Agnieszka author Hill, David author Snoek, Frank J. author Van Poppel, Mireille author Universitat Autònoma de Barcelona author 2018 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. Gestational diabetes mellitus Healthy eating Lifestyle intervention Motivational interviewing Overweight Physical activity Pregnancy Prevention Randomised controlled trial Association between gestational weight gain, gestational diabetes risk, and obstetric outcomes : A randomized controlled trial post hoc analysis