Association between gestational weight gain and pregnancy outcomes in women with diabetes
DOI:
https://doi.org/10.18203/2320-6012.ijrms20260005Keywords:
Gestational weight gain, Pre-pregnancy body mass index, Diabetes mellitus in pregnancy, Adverse pregnancy outcomesAbstract
Background: Hyperglycemia is a common complication of pregnancy, and the prevalence of both pregestational and gestational diabetes has increased substantially over the past decade. Hyperglycemia in pregnancy is associated with adverse maternal and neonatal outcomes. Pre-pregnancy weight and gestational weight gain (GWG) are important determinants of maternal and fetal health. To investigate the association between GWG and adverse maternal and neonatal outcomes in women with diabetes.
Methods: A retrospective study included 1,600 singleton pregnant women with diabetes who delivered at Rajavithi Hospital between January 2016 and December 2023. GWG was classified according to Institute of Medicine (IOM) recommendations based on pre-pregnancy body mass index (BMI).
Results: Among the 1,600 pregnancies, 4.81% were underweight, 44.69% normal weight, 30.94% overweight, and 19.56% obese. Excessive GWG was associated with increased risks of gestational hypertension (adjusted odds ratio (aOR) 5.70, 95% confidence interval (CI) 1.73-18.80), large-for-gestational-age (LGA) (aOR 2.22, 95% CI 1.63-3.01), macrosomia (aOR 1.97, 95% CI 1.05-3.70), and postpartum hemorrhage (aOR 2.58, 95% CI 1.24-5.40), while reducing the risk of small-for-gestational-age [SGA] (aOR 0.45, 95% CI 0.21-0.95). Insufficient GWG was associated with lower risks of preeclampsia (aOR 0.43, 95% CI 0.20-0.93) and LGA (aOR 0.64, 95% CI 0.42-0.96), but with a higher risk of preterm birth (aOR 1.87, 95% CI 1.11-3.15).
Conclusions: In women with diabetes, excessive GWG is associated with adverse maternal and neonatal outcomes. Insufficient GWG is associated with reduced risks of various adverse outcomes.
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References
Jatavan P, Luewan S, Sirilert S, Tongsong T. Trends in the prevalence of diabetes mellitus in pregnancy during the past two decades in Northern Thailand. Healthcare (Basel). 2023;11(9):1315.2. DOI: https://doi.org/10.3390/healthcare11091315
Zaccara TA, Paganoti CF, Mikami FCF, Francisco RPV, Costa RA. WHO criteria for diabetes in pregnancy: a retrospective cohort. BMC Pregnancy Childbirth. 2022;22:385. DOI: https://doi.org/10.1186/s12884-022-04708-w
Rasmussen KM, Yaktine AL, editors. Weight Gain during Pregnancy: Reexamining the Guidelines. Institute of Medicine, The National Academy Press; Washington, DC, USA. 2009.
Ćwiek D, Lubkowska A, Zimny M, Szymoniak K, Sipak-Szmigiel O. Weight gain during and after pregnancy in women with gestational diabetes mellitus-A preliminary study. Int J Environ Res Public Health. 2022;19(19):11959. DOI: https://doi.org/10.3390/ijerph191911959
Yee LM, Cheng YW, Inturrisi M, Caughey AB. Gestational weight loss and perinatal outcomes in overweight and obese women subsequent to diagnosis of gestational diabetes mellitus. Obesity (Silver Spring). 2013;21(4):770-74. DOI: https://doi.org/10.1002/oby.20490
Gou BH, Guan HM, Bi YX, Ding BJ. Gestational diabetes: weight gain during pregnancy and its relationship to pregnancy outcomes. Chin Med J (Engl). 2019;132(2):154-60. DOI: https://doi.org/10.1097/CM9.0000000000000036
American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2025. Diabetes Care. 2025;48(1):S27-49.
National Institutes of Health Consensus Development Conference Panel. National Institutes of Health Consensus Development Conference Statement: Diagnosing Gestational Diabetes Mellitus, 2013. Obstet Gynecol. 2013;122(2 Pt 1):358-69. DOI: https://doi.org/10.1097/AOG.0b013e31829c3e64
American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice.
Weight gain during pregnancy. Obstet Gynecol. 2013;121(1):210-12. DOI: https://doi.org/10.1097/01.AOG.0000425668.87506.4c
Lima Ferreira J, Voss G, Dória M, Sá Couto A, Príncipe RM. Benefit of insufficient gestational weight gain in obese women with gestational diabetes mellitus: A multicenter study in Portugal. Diabetes Metab Syndr. 2021;15(1):419-24. DOI: https://doi.org/10.1016/j.dsx.2021.01.020
Shi P, Liu A, Yin X. Association between gestational weight gain in women with gestational diabetes mellitus and adverse pregnancy outcomes: a retrospective cohort study. BMC Pregnancy Childbirth. 2021;21:508. DOI: https://doi.org/10.1186/s12884-021-03982-4
Guo Z, Lin L, Dong J, Lin J. Association between gestational weight gain and perinatal outcomes among women with gestational diabetes mellitus. Front Endocrinol (Lausanne). 2025;16:1531814. DOI: https://doi.org/10.3389/fendo.2025.1531814
Xie X, Liu J, García-Patterson A, Chico A, Mateu-Salat M, Amigó J, Adelantado JM, Corcoy R. Gestational weight gain and pregnancy outcomes in women with type 1 and type 2 diabetes mellitus. Acta Diabetol. 2023;60(5):621-9. DOI: https://doi.org/10.1007/s00592-023-02031-0
Xu H, Arkema EV, Cnattingius S, Stephansson O, Johansson K. Gestational weight gain and delivery outcomes: a population-based cohort study. Paediatr Perinat Epidemiol. 2021;35(1):47-56. DOI: https://doi.org/10.1111/ppe.12709
Chawanpaiboon S, Lucksanapanij M. Impact of maternal weight and gestational weight gain on postpartum hemorrhage and adverse outcomes: a case-control study. Int J Womens Health. 2025;17:3567-75. DOI: https://doi.org/10.2147/IJWH.S552037
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