The impact of gestational weight gain and diet on abnormal glucose tolerance during pregnancy in Hispanic women.

OBJECTIVE

To examine the association of gestational weight gain and dietary factors with abnormal glucose tolerance (AGT).

METHODS

We conducted a prospective cohort study among 813 Hispanic prenatal care patients in Massachusetts. Gestational weight gain and oral glucose tolerance test results were abstracted from medical records. Dietary intake was assessed using a semi-quantitative food frequency questionnaire. Target weight gain was based on BMI-specific weekly weight gain rates established by the Institute of Medicine (IOM).

RESULTS

We observed a statistically significant interaction between prepregnancy BMI and weight gain in relation to AGT (P < 0.01). Class II/III (BMI > or = 35 kg/m2) obese women who had a high rate of weight gain (>0.30 kg/week) or who exceeded target weight were 3-4 times as likely to develop AGT compared to women who gained within IOM ranges (OR = 4.2, 95% CI 1.1-16.0, OR = 3.2 95% CI 1.0-10.5, respectively). Decreasing levels of saturated fatty acids and energy-dense snack foods and increasing levels of fiber and polyunsaturated:saturated fat ratio were significantly associated with decreased risk of AGT, independent of gestational weight gain [corrected].

CONCLUSIONS

Weight gain among class II/III obese women and certain dietary components may represent modifiable risk factors for AGT.