Excessive weight gain during the first trimester of pregnancy appears to significantly increase the risk of gestational diabetes, according to a study published Monday in Obstetrics and Gynecology, the Los Angeles Times reports. Lead author Monique Hedderson of the Kaiser Permanente Division of Research and colleagues analyzed medical data on an ethnically diverse group of women who gave birth from 1996 through 1998. They identified 345 women who developed gestational diabetes and 800 who did not.

The study found that pregnant women whose first trimester weight gain exceeded Institute of Medicine recommendations had a 50% greater risk for developing gestational diabetes. Women who gained between 0.6 pounds and four pounds per week in the first trimester had an 80% greater risk for developing the condition, compared with women who gained weight at or below IOM's recommendations, the study found. Although obese women generally gained the least amount of weight during the first trimester, they had the greatest risk for developing the condition. There was no link between weight gain during the second trimester and gestational diabetes.

IOM's latest recommendations, which were issued last year, state that underweight women should gain a total 28 to 40 pounds during pregnancy, normal-weight women should gain 25 to 35 pounds, and overweight women should gain 15 to 25 pounds. Obese women -- those whose body mass index exceeds 30 -- should gain a maximum of 11 to 20 pounds.

Hedderson said, "As all pregnancies progress, an increase in insulin resistance occurs," adding, "Most women's beta cells are able to compensate by releasing more insulin, but if a woman has reduced beta cell capacity caused by weight gain, she may not be able to compensate for this normal occurrence." Obese women might enter pregnancy with such a high risk of developing gestational diabetes that any amount of weight gain could trigger the condition, Hedderson said (Stein, Los Angeles Times, 2/23).

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