Gestational weight gain ranges and maternal-infant adverse outcomes among Chinese women with gestation diabetes: a retrospective study

Objective: To identify the ranges of gestational weight gain for Chinese women with gestational diabetes based on the different pre-pregnancy body mass index group, and to investigate the association between gestational weight gain and maternal-infant adverse outcomes. Design A single-center retrospective cohort study. Setting A tertiary public women's and children's hospital in China. Population Women with gestational diabetes. Methods Retrospective analysis of 17,216 women with gestational diabetes who delivered singleton, registered between 2013 and 2018. Main outcome measures Gestational weight gain ranges, maternal-infant adverse outcomes. Results A total of 14,517 women were included finally. In comparison to the recommended gestational weight gain ranges by the National Academy of Medicine, the Chinese women with gestational diabetes in this study had a wider weight gain ranges, and faster rate of gestational weight gain. The risk of adverse outcomes increased steadily with gestational weight gain in the four body mass index groups. The ranges of gestational weight gain that were associated with lower risks of maternal-infant adverse outcomes were 15-20kg, 14-18kg, 4-8kg, and 0-4kg for the underweight, normal weight, overweight and obese groups, respectively. Conclusions The findings from this study can be used as a guideline for Chinese women with gestational diabetes. Healthcare professionals should provide targeted advice to women based on their pre-pregnancy body mass index to reduce the risks of maternal-infant adverse outcomes. Future high-quality and multi-center prospective studies are needed to validate our findings. Keywords Gestational weight gain, body mass index, gestational diabetes mellitus, maternal-infant adverse outcomes