Pregnant women who are just above average for weight and blood sugar are at a significantly higher risk than previously believed – and so are their babies -- according to a new study.
The research, published in the journal Diabetes Care, found such women are at higher risk than pregnant women who are obese with normal blood sugar or pregnant women who have gestational diabetes and a normal weight.
"These are women who have not been on our radar because they don't have gestational diabetes and aren't obese, but our study shows if you are one step away from each of those, you carry some significant risks," said lead researcher Dr. Boyd Metzger, of Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital.
"We need to address the combination of overweight and blood sugar of these women as urgently as we do for women who are obese or have gestational diabetes."
Metzger and colleagues found such women comprised about 6 percent of the total number of women they studied. Obese women made up 16 percent of the group and those with gestational diabetes accounted for 13.7 percent.
Researchers found women who are both obese and have gestational diabetes are at a much higher risk of having a problem pregnancy than women having only one of those conditions. One complication for these mothers is having large babies, the result of fat accumulation. Large babies increase the risk of injury to the baby during vaginal delivery, increasing the likelihood of a Cesarean section.
Among researchers’ findings:
• When the mothers are obese and have gestational diabetes, their babies weigh 340 grams more than babies of mothers with normal weight and blood sugar.
• When the mothers are overweight with above-average blood sugar levels, the babies weigh 214 grams more.
• Mothers of normal weight but with gestational diabetes have babies who weigh 164 grams more.
• Obese mothers with normal glucose levels have babies with an increased weight of 174 grams.
• Pregnant women with higher blood sugar and weight levels increase the odds that their babies will have higher insulin and lower blood sugar levels, which may trigger obesity and diabetes as early as childhood.
"The big message from this is when you look at the impact of nutrition, metabolism and weight on pregnancy outcomes, every woman – on her first prenatal visit -- should get a prescription for a session with a dietician and an appropriate healthy eating plan for her pregnancy," said Metzger. "This doesn't happen, but it should, and insurance companies should reimburse it."
The research was funded, in part, by the National Institutes of Health.