Impact of interpregnancy weight change on the risk of gestational diabetes mellitus during a second pregnancy in Chinese population: a retrospective cohort study

Objectives This study aimed to investigate the impact of interpregnancy weight changes (IPWC) on the gestational diabetes mellitus (GDM) in the second pregnancy.Design A single-centre retrospective cohort study was conducted in China.Setting Data were collected in Peking University Shenzhen Hospital...

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Main Authors: Ying Wang, Juan Yang, Chang Xu, Yuzhen Liu, Ao Yang, Shilin Zhong
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/1/e084282.full
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author Ying Wang
Juan Yang
Chang Xu
Yuzhen Liu
Ao Yang
Shilin Zhong
author_facet Ying Wang
Juan Yang
Chang Xu
Yuzhen Liu
Ao Yang
Shilin Zhong
author_sort Ying Wang
collection DOAJ
description Objectives This study aimed to investigate the impact of interpregnancy weight changes (IPWC) on the gestational diabetes mellitus (GDM) in the second pregnancy.Design A single-centre retrospective cohort study was conducted in China.Setting Data were collected in Peking University Shenzhen Hospital from 2013 January to 2021 February.Participants Participants include women who had two consecutive singleton deliveries after 28 gestational weeks (n=2372).Outcomes The GDM in the second pregnancy (s-GDM) was set as the outcome.Methods IPWC was defined as the change in body mass index between the first trimester of the second pregnancy and that of the first pregnancy, categorised into four groups with −1 kg/m² to <1 kg/m² as the reference. Adjusted ORs (aORs) with 95% CIs attained from multivariable logistic regression were used to assess the association between IPWC and s-GDM, in both total subjects and stratified subgroups.Results In the overall analysis, s-GDM was found to be significantly associated with IPWC value (aOR 1.111; 95% CI 1.038 to 1.190) and an IPWC category of ≥3 kg/m² (aOR 1.821; 95% CI 1.197 to 2.772). In the stratified analysis, the significant association between IPWC ≥3 kg/m² and s-GDM was evident only in the subgroups of an interpregnancy interval (IPI) of less than 36 months (aOR 2.210, 95% CI 1.251 to 3.904), under the age of 35 (aOR 1.854, 95% CI 1.204 to 2.857), non-diabetic status in the first pregnancy (f-ND) (aOR 1.872, 95% CI 1.143 to 3.065) and those with normal weight in the first pregnancy (aOR 1.936, 95% CI 1.174 to 3.193). The significant association between IPWC value and s-GDM was also shown only in these subgroups (p<0.05). In f-DN subgroup, even an IPWC category of 1 kg/m² to <3 kg/m² was significantly associated with s-GDM (aOR 1.486, 95% CI 1.044 to 2.117). IPWC < −1 kg/m² was not significantly associated with s-GDM either in the overall analysis or in the stratified analysis (p>0.05).Conclusion An IPWC of 3 kg/m² or higher may increase the risk of s-GDM, particularly among women with an IPI of less than 36 months, those under 35 years old, individuals without diabetes, or those with normal weight during their first pregnancy. The potential influence of prior GDM on the relationship between IPWC and s-GDM warrants further investigation.
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spelling doaj-art-d0cbc025ac154fa28148d452bfb7b3772025-02-03T09:35:08ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-084282Impact of interpregnancy weight change on the risk of gestational diabetes mellitus during a second pregnancy in Chinese population: a retrospective cohort studyYing Wang0Juan Yang1Chang Xu2Yuzhen Liu3Ao Yang4Shilin Zhong51 Department of Gerontology, Shanghai Sixth People`s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Infectious Diseases, Third People`s Hospital of Yichang City, Yichang, Hubei, ChinaDepartment of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, People`s Republic of ChinaPersonalized Healthcare& Biomarkers, AstraZeneca, Cambridge, United Kingdom.1 Center of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China1 Center of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, ChinaObjectives This study aimed to investigate the impact of interpregnancy weight changes (IPWC) on the gestational diabetes mellitus (GDM) in the second pregnancy.Design A single-centre retrospective cohort study was conducted in China.Setting Data were collected in Peking University Shenzhen Hospital from 2013 January to 2021 February.Participants Participants include women who had two consecutive singleton deliveries after 28 gestational weeks (n=2372).Outcomes The GDM in the second pregnancy (s-GDM) was set as the outcome.Methods IPWC was defined as the change in body mass index between the first trimester of the second pregnancy and that of the first pregnancy, categorised into four groups with −1 kg/m² to <1 kg/m² as the reference. Adjusted ORs (aORs) with 95% CIs attained from multivariable logistic regression were used to assess the association between IPWC and s-GDM, in both total subjects and stratified subgroups.Results In the overall analysis, s-GDM was found to be significantly associated with IPWC value (aOR 1.111; 95% CI 1.038 to 1.190) and an IPWC category of ≥3 kg/m² (aOR 1.821; 95% CI 1.197 to 2.772). In the stratified analysis, the significant association between IPWC ≥3 kg/m² and s-GDM was evident only in the subgroups of an interpregnancy interval (IPI) of less than 36 months (aOR 2.210, 95% CI 1.251 to 3.904), under the age of 35 (aOR 1.854, 95% CI 1.204 to 2.857), non-diabetic status in the first pregnancy (f-ND) (aOR 1.872, 95% CI 1.143 to 3.065) and those with normal weight in the first pregnancy (aOR 1.936, 95% CI 1.174 to 3.193). The significant association between IPWC value and s-GDM was also shown only in these subgroups (p<0.05). In f-DN subgroup, even an IPWC category of 1 kg/m² to <3 kg/m² was significantly associated with s-GDM (aOR 1.486, 95% CI 1.044 to 2.117). IPWC < −1 kg/m² was not significantly associated with s-GDM either in the overall analysis or in the stratified analysis (p>0.05).Conclusion An IPWC of 3 kg/m² or higher may increase the risk of s-GDM, particularly among women with an IPI of less than 36 months, those under 35 years old, individuals without diabetes, or those with normal weight during their first pregnancy. The potential influence of prior GDM on the relationship between IPWC and s-GDM warrants further investigation.https://bmjopen.bmj.com/content/15/1/e084282.full
spellingShingle Ying Wang
Juan Yang
Chang Xu
Yuzhen Liu
Ao Yang
Shilin Zhong
Impact of interpregnancy weight change on the risk of gestational diabetes mellitus during a second pregnancy in Chinese population: a retrospective cohort study
BMJ Open
title Impact of interpregnancy weight change on the risk of gestational diabetes mellitus during a second pregnancy in Chinese population: a retrospective cohort study
title_full Impact of interpregnancy weight change on the risk of gestational diabetes mellitus during a second pregnancy in Chinese population: a retrospective cohort study
title_fullStr Impact of interpregnancy weight change on the risk of gestational diabetes mellitus during a second pregnancy in Chinese population: a retrospective cohort study
title_full_unstemmed Impact of interpregnancy weight change on the risk of gestational diabetes mellitus during a second pregnancy in Chinese population: a retrospective cohort study
title_short Impact of interpregnancy weight change on the risk of gestational diabetes mellitus during a second pregnancy in Chinese population: a retrospective cohort study
title_sort impact of interpregnancy weight change on the risk of gestational diabetes mellitus during a second pregnancy in chinese population a retrospective cohort study
url https://bmjopen.bmj.com/content/15/1/e084282.full
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