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Am J Perinatol 2015; 32(01): 093-100
DOI: 10.1055/s-0034-1374815
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Does Maternal Body Mass Index Influence Treatment Effect in Women with Mild Gestational Diabetes?

Brian M. Casey
1   Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
,
Lisa Mele
2   The George Washington University Biostatistics Center, Washington, District of Columbia
,
Mark B. Landon
3   Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio
,
Catherine Y. Spong
4   Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda
,
Susan M. Ramin
5   Department of Obstetrics and Gynecology, University of Texas Health Science Center at Houston, Houston, Texas
,
Ronald J. Wapner
6   Department of Obstetrics and Gynecology, Columbia University, New York, New York
,
Michael W. Varner
7   Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
,
Dwight J. Rouse
8   Department of Obstetrics and Gynecology, University of Alabama, Birmingham, Alabama
,
John M. Thorp Jr.
9   Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina
,
Patrick Catalano
10   Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio
,
Margaret Harper
11   Department of Obstetrics and Gynecology, Wake Forest University Health Sciences, Winston-Salem, North Carolina
,
George Saade
12   Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
Yoram Sorokin
13   Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan
,
Alan M. Peaceman
14   Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois
,
for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network› Author Affiliations
Further Information

Publication History

04 March 2014

07 March 2014

Publication Date:
16 May 2014 (online)

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Abstract

Objective The aim of the article is to determine whether maternal body mass index (BMI) influences the beneficial effects of diabetes treatment in women with gestational diabetes mellitus (GDM).

Study Design Secondary analysis of a multicenter randomized treatment trial of women with GDM. Outcomes of interest were elevated umbilical cord c-peptide levels (> 90th percentile 1.77 ng/mL), large for gestational age (LGA) birth weight (> 90th percentile), and neonatal fat mass (g). Women were grouped into five BMI categories adapted from the World Health Organization International Classification of normal, overweight, and obese adults. Outcomes were analyzed according to treatment group assignment.

Results A total of 958 women were enrolled (485 treated and 473 controls). Maternal BMI at enrollment was not related to umbilical cord c-peptide levels. However, treatment of women in the overweight, Class I, and Class II obese categories was associated with a reduction in both LGA birth weight and neonatal fat mass. Neither measure of excess fetal growth was reduced with treatment in normal weight (BMI < 25 kg/m2) or Class III (BMI ≥ 40 kg/m2) obese women.

Conclusion There was a beneficial effect of treatment on fetal growth in women with mild GDM who were overweight or Class I and Class II obese. These effects were not apparent for normal weight and very obese women.

Keywords

gestational diabetes - BMI - treatment effect

Note

The project described was supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) [HD27915, HD34116, HD40485, HD34208, HD27869, HD40500, HD40560, HD34136, HD40544, HD27860, HD40545, HD53097, HD21410, HD27917, HD40512, HD53118, HD36801], General Clinical Research Centers Grant [M01-RR00034], and the National Center for Research Resources [UL1-RR024989, M01-RR00080, UL1-RR025764, C06-RR11234 ] and does not necessarily represent the official views of the NICHD or NIH.