Associations of the pre-pregnancy BMI and gestational BMI gain with pregnancy outcomes in Chinese women with gestational diabetes mellitus.

BACKGROUND Pre-pregnancy body mass index (BMI) and weight change in women with gestational diabetes mellitus (GDM) during pregnancy likely have an effect on pregnancy outcome. However, limited clinical evidence is available to support the correlation. AIMS To investigate the relationship of pre-pregnancy BMI and gestational BMI gains and their effect on pregnancy outcome among Chinese women with GDM. MATERIALS AND METHODS Data were collected from 1418 pregnant patients with GDM who received antenatal care and performed delivery in our hospital. Patients were categorized into groups based on pre-pregnancy and gestational BMI in order to evaluate the risk of pregnancy complications. After being diagnosed with GDM during pregnancy, every subject received advice on lifestyle modification and learned how to self-monitor glucose and administer insulin if needed. RESULTS LBW is likely to occur in underweight women with low pre-pregnancy BMI (ORs 2.96, P < 0.01). Obese women are more vulnerable to hypertension, macrosomia and preterm labor (ORs are 5.92, 2.92, 1.79 respectively; P < 0.05). Similar result is observed in overweight women (ORs are 2.72, 1.64, 1.45 respectively; P < 0.05). The prevalence of LBW was higher in gestational BMI gain of < 4 team and the teams of BMI gain > 6 were vulnerable to macrosomia. CONCLUSION An appropriate maternal pre-pregnancy BMI (18.5-24) followed by adequate gestational BMI gain (4~6) could reduce the risk of the maternal and infant complications.