Endocrine Abstracts

JOINT512

Background: Studies disagree that higher pre-pregnancy body mass index (pre-BMI) is associated with more significant weight gain during pregnancy. We aimed to assess factors associated with GWG in women with gestational diabetes mellitus (GDM).

Methods: The study involved 215 singleton pregnant women diagnosed with GDM who delivered at Vilnius University Hospital Santaros Klinikos from 2019 to 2023. Based on pre-BMI, women were categorized into group 1 - BMI < 18.5- 24.9 kg/m²; group 2-BMI 25-29.9; group 3 - BMI ≥ 30. According to the Institute of Medicine, the cut-off points for weight gain were set at ≤16 kg, ≤11.5 kg, and ≤9 kg for groups 1, 2, and 3, respectively. The association of pre-BMI, fasting plasma glucose up to 14 weeks of gestation (FG14w), FG, fasting insulin (FI), HOMA-IR, lipid profile, and CRP at weeks 24-28 with GWG was analyzed.

Results: There were 123 (57.2%),52 (24.2%) and 40 (18.6%) women in group 1, 2 and 3 respectively. The mean age was 31.9 ± SD 4.05 and did not differ between the groups. Excess weight gained 22 (17.9%), 14 (26.9%), and 12 (30%) of women in groups 1, 2, and 3, respectively. The biggest GWG was in group 1 – 12.5 ±4.9 kg, followed by groups 2- 8.9±5.5 and 3 - 5.7±5.5 (P<0.001). HOMA IR was 2.0 ± 1.4, 3.0 ± 2.4, and 4.4 ± 3.4 (P<0.001); HDL chol - 2.0 ± 0.4, 1.9 ± 0.4 and 1.7 ± 0.3 (P<0.001) in group 1, 2 and 3 respectively. FG14w, FG24-28w, hCRP, triglycerides (TG), and FI differed significantly between the groups (P<0,001 for all). Pre-BMI, HDL chol, and FG24-28w explained 24% of GWG variance in the whole group (R2 adjusted = 0.24, P<0.001). Only HDL chol correlated significantly with GWG in group 2, explaining 13% of the variance (R2 adjusted = 0.13, P = 0.005) and resulting in a significant OR of 19.2 (95% CI 2.2-166.4) and AUC of 0.81 (95% CI 0.6 - 0.9). None of the variables demonstrated a statistically significant association with GWG in groups 1 and 3.

Conclusions: GDM women with the highest pre-BMI gained the least weight during pregnancy. Pre-BMI, HDL chol, and FG24-28w were significant determinants of GWG in the whole group, but only HDL chol remained significant in women with pre-pregnancy overweight. Further research is needed to explore other possible factors related to GWG in women with GDM.