Association of pre-pregnancy BMI and postpartum weight retention with postpartum HbA(1c) among women with Type 1 diabetes

作者：Huang T; Brown F M; Curran A; James Todd T^*

来源：Diabetic Medicine, 2015, 32(2): 181-188.

DOI：10.1111/dme.12617

AimTo examine the association of pre-pregnancy BMI and postpartum weight retention with postpartum HbA(1c) levels in women with Type 1 diabetes.
MethodsWe longitudinally evaluated 136 women with Type 1 diabetes who received prenatal, pregnancy, and postpartum care through Joslin Diabetes Center's Diabetes and Pregnancy Program between 2004 and 2009. Weight, BMI and HbA(1c) concentrations were assessed before the index pregnancy and repeatedly monitored after delivery until 12months postpartum. We used linear mixed models to assess the association of postpartum HbA(1c) with pre-pregnancy BMI and postpartum weight retention.
ResultsThe mean HbA(1c) concentration increased from 49mmol/mol (6.6%) at 6weeks postpartum to 58mmol/mol (7.5%) by 10months postpartum, a level similar to the mean pre-pregnancy HbA(1c) concentration. Postpartum weight retention showed a linearly decreasing trend of 0.06kg/week (P<0.0001), with -0.1kg average postpartum weight retention by 1year postpartum. Compared with women with a pre-pregnancy BMI25kg/m(2), women with a lower pre-pregnancy BMI maintained a 3.4mmol/mol (0.31%) lower HbA(1c) concentration, after adjusting for several sociodemographic, reproductive and diabetes-related factors (P=0.03). There was a suggestion of a time-varying positive association between HbA(1c) and postpartum weight retention, with the most significant difference of 3.7mmol/mol (0.34%; P=0.05) at 30weeks postpartum among women with postpartum weight retention 5kg vs those with postpartum weight retention <5kg.
ConclusionsPre-pregnancy BMI and postpartum weight retention were positively associated with HbA(1c) during the first postpartum year in women with Type 1 diabetes. Interventions to modify the behaviours associated with these body weight factors before pregnancy and after delivery may help women with Type 1 diabetes maintain good glycaemic control after pregnancy.

• 出版日期2015-2