ArticleBMC pediatrics2026
Impact of gestational weight gain on adverse pregnancy outcomes in women with gestational diabetes: a retrospective cohort study.
Article in BMC pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study focuses on determining the relationships between gestational weight gain(GWG) that falls within, below, or exceeds the Institute of Medicine(IOM) guidelines and negative perinatal outcomes. We additionally evaluated if insufficient GWG is linked to negative outcomes in pregnant women with gestational diabete mellitus(GDM).
methodsA Population-based retrospective cohort was conducted using data from the Sina Health Information System (SINAEHR) between 05/01/2018 and 28/12/2024 on the 18,575 Iranian women with GDM from Mashhad University affiliated centers. GWG assigned categories based on IOM guidelines according to pre pregnancy BMI. Multivariable logistic regression was employed to examine the association between gestational weight gain (GWG) categories and adverse pregnancy outcomes.
resultsA total of 18,575 pregnant patients participated in the study. After adjusting for confounders, analysis revealed that excessive GWG was associated with increased odds of cesarean delivery (adjusted OR 1.62, 95% CI 1.49-1.77), NICU admission (adjusted OR 1.86, 95% CI 1.67-2.06) and macrosomia (adjusted OR 1.98, 95% CI 1.75-2.24) and insufficient GWG, was also correlated with increased risks of preterm birth (adjusted OR 2.32, 95% CI 2.05-2.63), NICU admission (adjusted OR 1.69, 95% CI 1.53-1.88) and lower odds of macrosomia. Additionally, inadequate GWG was associated with lower odds of hypertension disorders of pregnancy whereas excessive GWG significantly increased its risk (adjusted OR 2.23, 95% CI 1.94-2.57). These findings underscore the importance of optimal GWG for favorable pregnancy outcomes and highlight the differential risks associated with deviations from IOM guidelines.
conclusionInadequate or excessive gestational weight gain relative to IOM guidelines is associated with significant adverse pregnancy outcomes, including preterm birth, NICU admission, macrosomia, cesarean delivery and hypertension disorders of pregnancy. These findings highlight the necessity for careful monitoring and management of weight gain during pregnancy to optimize maternal and neonatal health. Implementing targeted counseling and interventions can help ensure women achieve recommended GWG, ultimately improving pregnancy outcomes.
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