Differences in gestational weight gain, hypertensive disorders of pregnancy, and postpartum glycemic control among glucose metabolism disorder types: A retrospective cohort study

PurposeThis study explores how diabetes type is associated with gestational weight gain (GWG), hypertensive disorders of pregnancy (HDP), and postpartum glycemic control levels in women with gestational hyperglycemia. MethodsParticipants comprised 757 women with diabetes mellitus, categorized as type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), overt diabetes in pregnancy (ODM), and gestational diabetes mellitus (GDM), who had delivered at 22 weeks gestation or later between January 2013 and December 2022, at X University, Japan.Data were extracted on pre-pregnancy body mass index (BMI), GWG, diabetes type, treatment during pregnancy and one-month postpartum, glycated albumin (GA) levels in the third trimester of pregnancy and one month postpartum, and other relevant variables.Kruskal-Wallis test was used to examine the association between pre-pregnancy BMI and diabetes type, and binomial logistic regression analysis was used to determine how GWG and the development of HDP is associated with pre-pregnancy BMI and diabetes type.Multiple regression analysis was performed to examine how differences in GA between the third trimester of pregnancy and the first postpartum month are associated with pre-pregnancy BMI and diabetes type. ResultsThe mean pre-pregnancy BMI (mean ± SD, kg/ m 2 ) among the T1DM, T2DM, ODM, and GDM groups differed significantly (21.7 ± 3.1, 29.3 ± 5.8, 29.3 ± 6.8, and 24.2 ± 5.8, respectively, p < .001).T1DM (Adjusted Odd Ratio [aOR]: 2.35, p = .013)and pre-pregnancy BMI ≧ 30.0 (aOR: 53.3, p < .001)were significantly associated with excessive GWG.ODM (aOR: 4.14, p = .003)was significantly associated with HDP, and T2DM (β = .33,p = .036)was significantly associated with increased GA. ConclusionThis study examined the association between diabetes type and pre-pregnancy BMI and weight gain during pregnancy, gestational hypertension, and postpartum glycemic control in women with diabetic-metabolic pregnancy.Results showed that T1DM and 2 categories of obesity were associated with excessive weight gain during pregnancy.ODM was also associated with a significantly higher risk of developing HDP, and T2DM was associated with significantly higher GA in the first postpartum month.The results suggest the need to support pregnant women from preconception to postpartum, taking into account the characteristics of each diabetes type, its mechanism of onset, and health behaviors.