Association between Pre-pregnancy BMI and Pregnancy Outcomes in Women with Gestational Diabetes: A Retrospective Cohort Study

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Abstract
Background & Objective: The specific influence of the pre-pregnancy body mass index (PPBMI) on women with gestational diabetes mellitus (GDM) is unclear. Our objective was to investigate how PPBMI categories affect pregnancy and neonatal outcomes in women with GDM. Methods: A retrospective cohort study was conducted using data from patients attending the Fujian Maternity and Child Health Hospital (Fuzhou, China) from 2021 to 2023. The participant records were stratified into four groups according to their BMI values: underweight, normal-weight, overweight, and obese. The pregnancy and neonatal outcomes for these BMI categories were analyzed using multivariable logistic regression. Results: The study included data from 2,909 pregnant women diagnosed with GDM. Underweight women with GDM showed significantly lower risks of pregnancy-induced hypertension (PIH) (adjusted OR, 0.26) and cesarean sections (adjusted OR, 0.55) but higher risks of low body weight (LBW) infants (adjusted OR, 3.40). Overweight and obese women experienced higher risks of PIH (adjusted OR, 2.96), cesarean sections (adjusted OR, 1.62), and macrosomia (adjusted OR, 1.43). Conclusion: PPBMIs significantly impact pregnancy outcomes in women with GDM. Both underweight and overweight/obese categories are associated with adverse outcomes, highlighting the need for pre-pregnancy counseling and interventions to achieve and maintain a healthy BMI. doi: https://doi.org/10.12669/pjms.41.1.10920 How to cite this: Zheng L, Liao Q, Liu J, Shi J, Chen Z, Lin L. Association between Pre-pregnancy BMI and Pregnancy Outcomes in Women with Gestational Diabetes: A Retrospective Cohort Study. Pak J Med Sci. 2025;41(1):37-43. doi: https://doi.org/10.12669/pjms.41.1.10920 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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