The Impact of Prepregnancy Body Mass Index and Gestational Weight Gain on Perinatal Outcomes for Women With Gestational Diabetes Mellitus

Worldviews Evid Based Nurs. 2018 Aug;15(4):313-322. doi: 10.1111/wvn.12305. Epub 2018 Jul 1.

Abstract

Background: Gestational diabetes mellitus (GDM), an obstetric disease that affects the health of pregnant women, is one of the key factors associated with perinatal mortality or disease.

Aims: To explore the impact of prepregnancy body mass index (BMI) and gestational weight gain (GWG) on perinatal outcomes for women with GDM.

Methods: With a retrospective study design, women were recruited who received prenatal checkups, gave birth at two teaching hospitals in southern Taiwan from 1995 to 2011, and received a diagnosis of GDM by an obstetrician. A trained research assistant collected the participants' data in each hospital's archives room. The researcher used a retrospective case study method to identify women who received a GDM diagnosis between 1995 and 2011.

Results: Women with GDM and with an overweight prepregnancy BMI were more likely to have cesarean deliveries and to use glucose-lowering medicines after delivery. Their newborns also had a higher birth weight. In addition, gestational hypertension and cesarean delivery were more common in women with GDM and with excessive GWG than in women with GDM and with normal GWG. The newborns of women with GDM and with excessive GWG had higher birth weights and more nuchal cord than those of women with GDM and with normal GWG. More women with GDM and with excessive GWG underwent blood glucose monitoring than did women with GDM and with normal GWG.

Linking evidence to action: The prepregnancy weight and GWG significantly affected perinatal outcomes in both the women with GDM themselves and their newborns. Healthcare professionals must provide childbearing women with additional health education in the areas of health promotion, nutrition, weight control, exercise, and maintaining regular everyday lives.

Keywords: gestational diabetes mellitus; gestational weight gain; perinatal outcomes; prepregnancy body mass index; retrospective study design.

MeSH terms

  • Adult
  • Analysis of Variance
  • Body Mass Index*
  • Diabetes, Gestational / epidemiology
  • Diabetes, Gestational / etiology*
  • Female
  • Humans
  • Middle Aged
  • Overweight / complications*
  • Overweight / epidemiology
  • Pregnancy
  • Prenatal Care / methods
  • Retrospective Studies
  • Taiwan
  • Weight Gain / physiology*