Optimal gestational weight gain in women with pregestational type 2 diabetes: a population-based cohort study in China
Abstract Background The global prevalence of pregestational type 2 diabetes mellitus (T2DM) has increased concurrently with increasing rates of overweight and obesity. Effective weight management during pregnancy is critically associated with maternal and neonatal outcomes. However, no universally a...
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BMC
2025-08-01
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| Series: | Diabetology & Metabolic Syndrome |
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| Online Access: | https://doi.org/10.1186/s13098-025-01782-w |
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| author | Yiwei Xue Zifeng Cui Xinyu Shu Juan Juan Xin Kang Mi Yao Xu Chen Zhuo Wei Lingyi Kong Haitian Chen Shihong Cui Fengchun Gao Ping Zhu Jianying Yan Xia Xu Li Zhang Yanxia Wang Yang Mi Huixia Yang |
| author_facet | Yiwei Xue Zifeng Cui Xinyu Shu Juan Juan Xin Kang Mi Yao Xu Chen Zhuo Wei Lingyi Kong Haitian Chen Shihong Cui Fengchun Gao Ping Zhu Jianying Yan Xia Xu Li Zhang Yanxia Wang Yang Mi Huixia Yang |
| author_sort | Yiwei Xue |
| collection | DOAJ |
| description | Abstract Background The global prevalence of pregestational type 2 diabetes mellitus (T2DM) has increased concurrently with increasing rates of overweight and obesity. Effective weight management during pregnancy is critically associated with maternal and neonatal outcomes. However, no universally accepted guidelines for gestational weight gain (GWG) in high-risk pregnancies with T2DM currently exist. Methods A nationwide, multicenter cohort of 2078 T2DM pregnancies was analyzed, categorizing GWG based on latest Chinese guidelines. Multivariate regression analyses were performed to evaluate the impact of GWG deviations on adverse pregnancy outcomes. Interquartile range (IQR) analysis and restricted cubic splines were used to determine BMI-specific GWG targets. Results The results showed that insufficient GWG was protective against cesarean delivery, large-for-gestational-age (LGA), and macrosomia but increased risks of preterm birth and congenital anomalies. Excessive GWG significantly elevated risks of preeclampsia, LGA, macrosomia, and neonatal hypoglycemia, while protecting against small-for-gestational-age (SGA). Using interquartile range method, we identified GWG ranges for normal-weight, overweight, and obese women were 7.0–12.5 kg, 5.0–11.0 kg, and 4.0–11.2 kg, respectively. Restricted cubic splines suggested relaxing the lower limit to 6 kg for normal BMI but showed risks below 1.8 kg. For overweight and obese women, GWG below guideline limits was beneficial. Conclusion The current GWG guidelines may not fully suit T2DM pregnancies, particularly for overweight and obese women, highlighting the need for BMI-specific recommendations to optimize maternal and neonatal outcomes. |
| format | Article |
| id | doaj-art-773812addbee4e1292c1cdcbc3f99bbd |
| institution | Kabale University |
| issn | 1758-5996 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj-art-773812addbee4e1292c1cdcbc3f99bbd2025-08-20T03:44:06ZengBMCDiabetology & Metabolic Syndrome1758-59962025-08-0117111110.1186/s13098-025-01782-wOptimal gestational weight gain in women with pregestational type 2 diabetes: a population-based cohort study in ChinaYiwei Xue0Zifeng Cui1Xinyu Shu2Juan Juan3Xin Kang4Mi Yao5Xu Chen6Zhuo Wei7Lingyi Kong8Haitian Chen9Shihong Cui10Fengchun Gao11Ping Zhu12Jianying Yan13Xia Xu14Li Zhang15Yanxia Wang16Yang Mi17Huixia Yang18Department of Obstetrics and Gynecology and Reproductive Medicine, Peking University First HospitalDepartment of Obstetrics and Gynecology and Reproductive Medicine, Peking University First HospitalDepartment of Obstetrics and Gynecology and Reproductive Medicine, Peking University First HospitalDepartment of Obstetrics and Gynecology and Reproductive Medicine, Peking University First HospitalDepartment of Obstetrics and Gynecology and Reproductive Medicine, Peking University First HospitalDepartment of General Practice, Peking University First HospitalTianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Obstetrics and GynecologyTianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Obstetrics and GynecologyDepartment of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou UniversityDepartment of Obstetrics, Jinan Maternity and Child Care HospitalDepartment of Obstetrics, Jinan Maternity and Child Care HospitalDepartment of Obstetrics and Gynecology, Fujian Maternity and Child Health HospitalDepartment of Obstetrics and Gynecology, Fujian Maternity and Child Health HospitalDepartment of Obstetrics, Nanjing Women and Children’s Health Care HospitalDepartment of Obstetrics, Northwest Women and Children’s HospitalDepartment of Obstetrics, Northwest Women and Children’s HospitalDepartment of Obstetrics and Gynecology and Reproductive Medicine, Peking University First HospitalAbstract Background The global prevalence of pregestational type 2 diabetes mellitus (T2DM) has increased concurrently with increasing rates of overweight and obesity. Effective weight management during pregnancy is critically associated with maternal and neonatal outcomes. However, no universally accepted guidelines for gestational weight gain (GWG) in high-risk pregnancies with T2DM currently exist. Methods A nationwide, multicenter cohort of 2078 T2DM pregnancies was analyzed, categorizing GWG based on latest Chinese guidelines. Multivariate regression analyses were performed to evaluate the impact of GWG deviations on adverse pregnancy outcomes. Interquartile range (IQR) analysis and restricted cubic splines were used to determine BMI-specific GWG targets. Results The results showed that insufficient GWG was protective against cesarean delivery, large-for-gestational-age (LGA), and macrosomia but increased risks of preterm birth and congenital anomalies. Excessive GWG significantly elevated risks of preeclampsia, LGA, macrosomia, and neonatal hypoglycemia, while protecting against small-for-gestational-age (SGA). Using interquartile range method, we identified GWG ranges for normal-weight, overweight, and obese women were 7.0–12.5 kg, 5.0–11.0 kg, and 4.0–11.2 kg, respectively. Restricted cubic splines suggested relaxing the lower limit to 6 kg for normal BMI but showed risks below 1.8 kg. For overweight and obese women, GWG below guideline limits was beneficial. Conclusion The current GWG guidelines may not fully suit T2DM pregnancies, particularly for overweight and obese women, highlighting the need for BMI-specific recommendations to optimize maternal and neonatal outcomes.https://doi.org/10.1186/s13098-025-01782-wType 2 diabetes mellitusGestational weight gainAdverse pregnancy outcomes |
| spellingShingle | Yiwei Xue Zifeng Cui Xinyu Shu Juan Juan Xin Kang Mi Yao Xu Chen Zhuo Wei Lingyi Kong Haitian Chen Shihong Cui Fengchun Gao Ping Zhu Jianying Yan Xia Xu Li Zhang Yanxia Wang Yang Mi Huixia Yang Optimal gestational weight gain in women with pregestational type 2 diabetes: a population-based cohort study in China Diabetology & Metabolic Syndrome Type 2 diabetes mellitus Gestational weight gain Adverse pregnancy outcomes |
| title | Optimal gestational weight gain in women with pregestational type 2 diabetes: a population-based cohort study in China |
| title_full | Optimal gestational weight gain in women with pregestational type 2 diabetes: a population-based cohort study in China |
| title_fullStr | Optimal gestational weight gain in women with pregestational type 2 diabetes: a population-based cohort study in China |
| title_full_unstemmed | Optimal gestational weight gain in women with pregestational type 2 diabetes: a population-based cohort study in China |
| title_short | Optimal gestational weight gain in women with pregestational type 2 diabetes: a population-based cohort study in China |
| title_sort | optimal gestational weight gain in women with pregestational type 2 diabetes a population based cohort study in china |
| topic | Type 2 diabetes mellitus Gestational weight gain Adverse pregnancy outcomes |
| url | https://doi.org/10.1186/s13098-025-01782-w |
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