Inappropriate gestational weight gain impacts maternofetal outcomes in gestational diabetes

The present study evaluated the association between the dimension of deviation from appropriate gestational weight gain (GWG) and adverse maternofetal outcomes in women with gestational diabetes mellitus (GDM).

We performed a multicentric retrospective study and classified Women as within GWG, insufficient (IGWG), or excessive (EGWG) compared to the Institute of Medicine recommendations. The study calculated EGWG and IGWG for each prepregnancy BMI category. It defined Large-for-gestational-age (LGA) and macrosomia as a birthweight more than the 90th percentile for the gestational age and newborn weight greater than 4000 g, respectively. After the analysis, the study found-

• Enrollment of 18961 pregnant women: 39.7% with IGWG and 27.8% with EGWG. 

• Association between an EGWG over 3 kg and a higher risk of LGA infants and macrosomia in prepregnancy normal-weight women. 

• Association between an EGWG greater than 4 kg and a higher risk of LGA infants and macrosomia in obese women.
• Association between an EGWG above 3.5 kg and a greater risk of LGA infants, macrosomia, preeclampsia, and pregnancy-induced hypertension in overweight women.
• Association between an IGWG less than −3.1 kg or −3kg and a greater risk of small-for-gestational-age [SGA] infants in women with normal and underweight, respectively.

This study proves that improper gestational weight gain is associated with an increased risk for adverse maternofetal outcomes, irrespective of prepregnancy BMI. Beyond glycemic control, weight management in women with GDM must give special attention to prevent adverse pregnancy outcomes.

Monteiro SS, Santos TS, Fonseca L, et al. Inappropriate gestational weight gain impact on maternofetal outcomes in gestational diabetes. Annals of Medicine. 2023;55(1):207-214. DOI: 10.1080/07853890.2022.2159063