Gestational Diabetes

GDM: Calories (2016)

• Intervention
  In women with GDM, what is the effect of caloric consumption on fetal/neonatal and maternal outcomes?

  • Conclusion
    The evidence of the effect of varying levels of caloric consumption on glycemic control, maternal weight gain, fetal growth or birth weight and adverse fetal or neonatal and maternal outcomes in women with GDM is inconclusive. Limited research did not find significant differences in most outcomes with reported intakes of 1,384kcal to 1,863kcal per day in women with pre-pregnancy body mass index (BMI) of 22.4±3.2kg/m² to 38.0±0.7kg/m². In one study of women who began pregnancy as obese, gestational weight gain slowed after intervention with reported intakes of 1,560kcal and 1,630kcal per day, without adverse effects. 
    
    Results of the studies were confounded by use of reported vs. actual caloric intakes (possible under-reporting), tendency of the women to over-restrict caloric intake vs. prescribed, inconsistent stratification by pre-pregnancy BMI and pre-pregnancy weights not described, making comparison and synthesis of the research challenging. More research is needed to elucidate the effect of calorie consumption (kcal per kg pre-pregnancy body weight), independent of other factors, on fetal or neonatal and maternal outcomes.
  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In women with GDM, what is the effect of caloric consumption on fetal/neonatal and maternal outcomes?
    • Detail
    • Quality Rating Summary
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    • Worksheets
      • Ho L, Benzie IFF, Lao TT. Relationship between caloric intake and pregnancy outcome in diet-treated gestational diabetes mellitus. Nursing & Health Sci. 2005; 7:15-20.
      • Rae A, Bond D, Evans S, North F, Roberman B, Walters B. A randomised controlled trial of dietary energy restriction in the management of obese women with gestational diabetes.  Aust N Z J Obstet Gynaecol 2000;40(4):416-422.
      • Romon M, Nuttens MC, Vambergue A, Verier-Mine O, Biausque S, Lemaire C, Fontaine P, Salomez JL, Beuscart R. Higher carbohydrate intake is associated with decreased incidence of newborn macrosomia in women with gestational diabetes.  J Am Diet Assoc 2001;101(8):897-902.
  • Search Plan and Results: GDM: Calories 2014