Table 2.
Metabolic status at 24–28 weeks, 35–37 weeks, and birth outcomes in DALI participants, according to gestational weight gain from pre-pregnancy.
| Gestational Weight Gain Group | <1.80 kg at Baseline | ≥1.80 kg at Baseline | <5.65 kg to 24–28 Weeks | ≥5.65 kg to 24–28 Weeks | <9.5 kg to 35–37 Weeks † | ≥9.5 kg to 35–37 Weeks † |
|---|---|---|---|---|---|---|
| n = 215 | n = 216 | n = 203 | n = 201 | n = 156 | n = 158 | |
| 24–28 weeks | ||||||
| Weight (kg) | 96.5 ± 12.4 | 100.7 ± 12.8 ** | 96.7±12.7 | 100.4±12.7* | 96.7 ± 12.7 | 100.2 ± 12.6 * |
| Gestational weight gain (kg) # | 2.3 ± 3.9 | 9.3 ± 4.3 *** | 1.7±3.3 | 9.9±3.8*** | 2.0 ± 3.5 | 9.4 ± 4.3 *** |
| Fasting blood glucose (BG) (mmol/l) # | 4.62 ± 0.40 | 4.66 ± 0.42 * | 4.61±0.40 | 4.66±0.43** | 4.58 ± 0.36 | 4.57 ± 0.37 * |
| 1-h glucose (mmol/l) # | 7.73 ± 1.58 | 7.81 ± 1.66 | 7.74±1.59 | 7.83±1.68 | 7.52 ± 1.29 | 7.39 ± 1.49 |
| 2-h glucose (mmol/l) # | 6.34 ± 1.23 | 6.21 ± 1.24 | 6.33±1.26 | 6.22±1.19 | 6.18 ± 1.02 | 5.98 ± 1.13 |
| HOMA-IR # | 2.88 (2.17, 3.83) | 3.13 (2.39, 4.45) * | 2.80 (2.07, 3.76) | 3.15 (2.46, 4.47) *** | 2.84 (2.17, 3.69) | 3.03 (2.26, 4.29) *** |
| HOMA insulin secretion # | 256 (190, 366) | 285 (200, 393) | 264 (189, 345) | 283 (204, 407) * | 269 (193, 343) | 300 (208, 420) |
| Stumvoll phase 1 # | 1757 (1292, 2308) | 1888 (1404, 2347) * | 1675 (1276, 2256) | 1919 (1403, 2378) *** | 1612 (1287, 2255) | 1929 (1494, 2366) *** |
| Stumvoll phase 2 # | 454 (337, 588) | 484 (365, 598) * | 433 (335, 576) | 496 (368, 607) *** | 418 (336, 576) | 495 (380, 604) *** |
| 35–37 weeks | ||||||
| Weight (kg)† | 100.3 ± 12.3 | 104.9 ± 13.0 ** | 100.1 ± 12.6 | 105.2 ± 12.8 ** | 99.4 ± 12.8 | 105.7 ± 12.3 *** |
| Gestational weight gain (kg) #† | 6.2 ± 5.3 | 13.4 ± 5.7 *** | 5.4 ± 4.5 | 14.5 ± 4.9 *** | 4.7 ± 3.7 | 14.9 ± 4.4 *** |
| Fasting BG (mmol/l) #$ | 4.57 ± 0.45 | 4.60 ± 0.51 | 4.55 ± 0.45 | 4.61 ± 0.51 * | 4.49 ± 0.43 | 4.53 ± 0.43 ** |
| 1-h glucose (mmol/l) #$ | 8.20 ± 1.61 | 8.46 ± 1.57 | 8.21 ± 1.54 | 8.45 ± 1.67 * | 8.01 ± 1.37 | 8.17 ± 1.47 * |
| 2-h glucose (mmol/l) #$ | 6.74 ± 1.28 | 6.58 ± 1.21 | 6.82 ± 1.31 | 6.51 ± 1.14 * | 6.63 ± 1.21 | 6.43 ± 1.09 |
| HOMA-IR #$ | 3.11 (2.35, 4.46) | 3.38 (2.55, 4.60) | 2.96 (2,25, 4.32) | 3.45 (2.62, 4.76) ** | 2.66 (2.21, 4.04) | 3.47 (2.70, 4.74) *** |
| HOMA insulin secretion #$ | 345 (234, 565) | 354 (250, 483) | 346 (227, 478) | 351 (252, 531) | 324 (217, 445) | 367 (256, 531) |
| Stumvoll phase 1 #$ | 2469 (1722, 3174) | 2518 (1898, 3117) | 2403 (1723, 3124) | 2561 (1917, 3200) ** | 2383 (1732, 3026) | 2684 (2162, 3354) *** |
| Stumvoll phase 2 #$ | 629 (441, 801) | 639 (497, 786) | 618 (450, 790) | 652 (497, 810) ** | 608 (452, 766) | 684 (554, 841) *** |
| Birth | N = 198 | N = 195 | N = 194 | N = 194 | N = 154 | N = 158 |
| Gestation at birth (weeks) | 39.5 ± 2.6 | 39.6 ± 1.7 | 39.8 ± 1.6 | 39.5 ± 1.7 | 39.8 ± 1.4 | 39.8 ± 1.3 |
| Gender (male) | 102/198 (52%) | 94/195 (48%) | 101/194 (52%) | 94/194 (49%) | 84/154 (55%) | 74/158 (47%) |
| Birthweight | 3490 ± 538 | 3479 ± 557 | 3457 ± 541 | 3505 ± 551 | 3477 ± 503 | 3602 ± 515 |
| Birthweight ≥4 (kg) | 37/195 (19%) | 34/195 (17%) | 33/192 (17%) | 35/193 (18%) | 25/153 (16%) | 39/157 (25%) * |
| Birthweight <2.5 (kg) | 8/195 (4%) | 8/195 (4%) | 8/192 (4%) | 8/193 (4%) | 5/153 (3%) | 2/157 (1%) |
| Large for Gestational Age | 26/187 (14%) | 25/186 (13%) | 23/186 (12%) | 26/182 (14%) | 13/150 (9%) | 31/150 (21%) ** |
| Small for Gestational Age | 12/186 (7%) | 16/186 (9%) | 15/186 (8%) | 13/182 (7%) | 10/150 (7%) | 9/150 (6%) |
| Preterm birth | 8/194 (4%) | 14/195 (7%) | 8/192 (4%) | 14/192 (7%) | 2/153 (1%) | 4/157 (3%) |
| Induction of labor or planned caesarean section | 70/188 (37%) | 82/187 (44%) | 76/186 (41%) | 75/184 (41%) | 61/151 40% | 60/148 41% |
| Caesarean section | 51/190 (27%) | 73/190 (38%) * | 58/188 (31%) | 65/187 (35%) | 45/153 (29%) | 53/151 (35%) |
| Pre-eclampsia | 4/181 (2%) | 10/187 (5%) | 7/181 (4%) | 8/183 (4%) | 4/147 (3%) | 5/148 (3%) |
| Neonatal Intensive Care Unit admission | 19/170 (11%) | 18/185 (10%) | 19/173 (11%) | 19/179 (11%) | 14/145 (10%) | 14/144 (10%) |
| GDM total | 71/183 (39%) | 61/175 (35%) | 68/185 (37%) | 63/175 (36%) | 40/153 (26%) | 45/155 (29%) |
For the continuous outcomes, the differences between the groups were tested with multilevel regression models (country and individual as levels), and adjusted for the gestational age at the outcome measurement. For the dichotomous outcomes, logistic regression models were performed, and were adjusted for country and gestational age at outcome measurement. The data are adjusted for the pre-pregnancy BMI and fasting glucose at baseline. * p < 0.05; ** p < 0.01; *** p < 0.001. #—regression models were additionally adjusted either for value at baseline or for pre-pregnancy BMI when GWG was the outcome. $—value of 24–28 weeks carried forward to 35–37 weeks when GDM was diagnosed at 24–28 weeks. †—excluding women with GDM at 24–28 weeks, based on local glucose values. Numbers in bold highlight statistically significant comparisons.