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Maternal obesity and risk of gestational diabetes mellitus: A meta-analysis

¹Division of Reproductive Health, Centers for Disease Control and Prevention, Mailstop K-23, 1600 Clifton Road, Atlanta, Georgia 30333 USA
²Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, 750 Washington St., Boston, Massachusetts 02111 USA

ABSTRACT

Maternal obesity and risk of gestational diabetes mellitus: A meta-analysis

Objective: Numerous studies in the United States and elsewhere have reported an increased risk of gestational diabetes mellitus (GDM) among women who are overweight or obese compared with lean or normal-weight women. Despite the number and overall consistency of studies reporting a higher risk of GDM with increasing weight or body mass index (BMI), the magnitude of the association remains uncertain. This meta-analysis was conducted to better estimate this risk and to explore differences across studies.

Research Design and Methods: We identified studies from three sources: 1) a PubMed search of relevant articles published between January 1980 and January 2006; 2) reference lists of publications selected from the PubMed search; and 3) reference lists of review articles on obesity and maternal outcomes published between January 2000 and January 2006. We used a Bayesian model to perform the meta-analysis and meta-regression. We included cohort-designed studies that reported obesity measures reflecting pregnancy body mass, had a normal-weight comparison group, and presented data allowing a quantitative measurement of risk.

Results: Twenty studies were included in the meta-analysis. The unadjusted odds ratios of developing GDM were 2.14 (95% CI: 1.82-2.53), 3.56 (95% CI: 3.05-4.21), and 8.56 (95% CI: 5.07-16.04), respectively, among overweight, obese, and severely obese compared with normal-weight pregnant women. The meta-regression analysis found no evidence that these estimates were affected by selected study characteristics (publication date, study location, parity, type of data collection [retrospective vs.prospective], and prevalence of GDM among normal-weight women).

Conclusion: Our findings indicate that high maternal weight is associated with a substantially higher risk of GDM.

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