Excess gestational weight gain (GWG) is particularly important in gestational diabetes mellitus (GDM) where it increases risks of pregnancy and post-partum complications. We sought to assess self-awareness of body mass index (BMI) and GWG among women with GDM and the association between self-awareness and adherence to Institute of Medicine (IOM) GWG guidelines.METHODS:
Cross-sectional study of women >18 years of age, fluent in English or Spanish, who were diagnosed with GDM (by Carpenter-Coustan criteria or Glucose Challenge Test >200mg/dl), delivered at term and received postpartum inpatient care at Women and Infants Hospital between in 2016. Post-partum day 2 surveys asked participants to assess their BMI, BMI classification, and GWG category (not enough, appropriate, or too much). Chart abstraction was used to obtain actual BMI, GWG, demographic data and pregnancy outcomes. Women who appropriately categorized their BMI and GWG were compared to those who did not with respect to GWG that was within or exceeded IOM guidelines (<40 lb if BMI <25 kg/m2; <25 lb if BMI 25-29.9 kg/m2; <20 lb if BMI >30 kg/m2).RESULTS:
Of 220 women approached, 146 (66%) women met study criteria and consented; 98/146 (67%) exceeded IOM GWG guidelines. Women who exceeded guidelines compared to those who did not had similar baseline characteristics except with regard to first prenatal BMI (32.9 v. 30 kg/m2; p<0.04- Table). The two groups did not differ with regard to BMI self-awareness; 41.8% of those who gained excess GWG correctly categorized their BMI compared to 56.3% of those who limited their GWG; (p=0.11). However, women who exceeded GWG guidelines were more likely to lack self-awareness of their GWG. Only 18.4% of women who gained excess weight correctly classified their GWG, compared to 91.7% of the women who limited their GWG; (p<0.001).CONCLUSION:
A majority of women with GDM exceed GWG IOM guidelines and are unaware of this excess weight gain. We must work to better educate women on GWG not only to help them adhere to the IOM goals but also to mitigate the associated pregnancy and post-partum risks.