The Body Composition in Early Pregnancy is Associated with the Risk of Development of Gestational Diabetes Mellitus Late During the Second Trimester.
Level 3 - non-randomized controlled study
Prospective observational cohort study
PubMed 32753921 · doi:10.2147/DMSO.S245155
What was done
A prospective cohort of 1,318 pregnant women was recruited at Guiyang Maternal and Child Health Care Hospital. Body composition was assessed at 13 weeks of gestation using bioelectrical impedance analysis (BIA), measuring fat mass percentage (FMP), skeletal muscle mass percentage (SMMP), and fat mass index (FMI, fat mass in kg / height in m²). Pre-pregnancy BMI was recorded. Associations between these metrics and gestational diabetes mellitus (GDM) diagnosed via glucose tolerance screening in the late second trimester were evaluated.
What was found
Of the 1,318 participants, 249 developed GDM and 1,069 had normal glucose tolerance (NGT). Women who developed GDM had significantly higher FMI and FMP (P < 0.001) and lower SMMP (P < 0.001) at 13 weeks compared to NGT controls. Pre-pregnancy overweight (pre-BMI ≥ 24 kg/m²) was associated with increased GDM risk (adjusted OR 2.604, 95% CI 1.846–3.673). An FMP > 28% was also associated with increased GDM risk (adjusted OR 1.572, 95% CI 1.104–2.240). The area under the ROC curve for predicting GDM was 65.8% for FMI and 67.2% for pre-pregnancy BMI.
Why it matters
Early-pregnancy body fat composition relates to subsequent GDM risk, but specialized bioimpedance fat mass metrics provide no predictive advantage over standard pre-pregnancy BMI.
Limits
The study was conducted at a single center in China, limiting generalizability to other ethnic groups and populations. Bioimpedance analysis in early pregnancy can be influenced by changes in maternal hydration. Both FMI and BMI demonstrated only modest discriminatory accuracy (AUC < 70%), meaning neither is sufficient as a standalone predictive screening tool.
Cited by
- supports Having higher muscle mass during pregnancy is protective against developing gestational diabetes.