UPBEAT: is fat gain during pregnancy linked to diabetes in obese women?

Professor Lucilla Poston, Dr Dharmintra Pasupathy, Mr Paul Seed, Dr Annette Briley, Dr Nashita Patel, Dr Carolyn Gill, Ms Angela Flynn, Ms Claire Singh, CRLN research midwives on behalf of the UPBEAT Consortium

The way the body changes during pregnancy is different in obese women. Researchers think this may be linked to diabetes and other pregnancy risks.

During pregnancy, changes in women’s hormones make them gain weight and fat to support the healthy growth of the baby. In obese mothers, these changes are different: they put on weight at a different rate, and store it in different places. We think that this might play a role in problems like gestational diabetes and retaining too much extra weight after birth. Not losing this extra weight can make complications more likely if the woman decides to become pregnant again.  

We know surprisingly little about how and where the body gains fat during pregnancy. In turn, we don’t know how this is related to diabetes or how easy it will be to lose weight after birth.

During the UPBEAT study, researchers measured the distribution of fat in obese women during pregnancy and for 6 months afterwards. Fat is measured using “skin folds”: when you pinch your skin, the amount of fat under the skin affects how much you can grab. Looking at these skin folds lets doctors see how much fat there is in different areas of the body. Significantly, in obese women who got diabetes during pregnancy, treating the diabetes around 27-28 weeks of pregnancy caused them to gain less fat, more slowly. Six months after birth, the women had also lost the extra weight put on during pregnancy.

This study shows that using skin folds to measure fat during pregnancy could be a useful way of predicting diabetes. We have also shown that treating diabetes during pregnancy decreases fat gain: this is important as it allows obese mothers to stay closer to a healthy weight, lowering the chance of complications for mothers and their babies.

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This study takes place in a Tommy's centre and is funded by Tommy's, the National Institute for Health Research, the Medical Research Council, and the Guy's and St Thomas' Trust Biomedical Research Centre Biomarker Cluster Board

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