The factors influencing glucose intolerance through the second trimester; weight gain and change in dietary habits

Abstract

Purpose

Glucose intolerance in pregnancy is likely to occur, as there is an increase in human placenta lactogen by the second trimester. We presumed that changing dietary habits and approximately 10-kg weight gain during pregnancy most likely influenced this condition. Thus, a pregnant woman should be encouraged to reconsider her dietary habits. In this study we examined the factors influencing glucose intolerance with a focus on weight gain and change in dietary habits through the second trimester.

Methods

This longitudinal study examined pregnant women from the first trimester through the second trimester. We recruited 180 pregnant women who were in their first trimester and who attended a single hospital prenatal clinic between March 2018 and June 2019. Patient characteristics included age, pre-pregnancy body mass index (BMI), maternal weight gain until the second trimester, blood glucose levels in the second trimester, dietary habits, and a brief dietary history questionnaire (BDHQ). A blood glucose level of 140 mg/dl or more during the second trimester placed the patient in the glucose intolerance group and a glucose level less than 140 mg/dl placed the patient in the normal group. Data analysis was performed using the chi-square test and the t-test for the comparison of dietary habits between the first trimester and the second trimester. Binominal logistic regression analysis was used to investigate the factors influencing glucose intolerance. We analyzed the data using the following covariates: pre-pregnancy BMI, weight gain until the second trimester, age, and energy intake.

Results

A total of 147 pregnant women participated in the study. In the two groups (35 in the glucose group and 112 in the normal group), change in the women's dietary habits included having breakfast, carefully monitoring the speed at which they ate, and checking nutritional facts when they purchased food. Factors influencing glucose intolerance were found to be pre-pregnancy BMI and weight gain until the second trimester. The analysis showed the following results: odds ratio [OR], 1.18; 95% confidence interval [CI], 1.05-1.32, and OR 0.78; 95% CI 0.61-0.99.

Conclusion

Pregnant women experience nausea, vomiting, and/or changes in their taste for food in the first trimester. However, we considered that nutrition education and an appropriate weight gain until the second trimester would prevent glucose intolerance. In addition, optimal gestational weight gain must be examined in each trimester of gestation.