Prepregnancy body mass index and weight change on postpartum diabetes risk among gestational diabetes women

OBJECTIVE: To evaluate the effects of prepregnancy BMI and weight change from prepregnancy to postpartum on postpartum type 2 diabetes (T2D) risk among women with gestational diabetes (GDM). METHODS: A retrospective cohort study in 1,263 GDM women at 1-5 years after delivery was performed. Cox proportional hazards regression models were used to evaluate the association of prepregnancy BMI and weight change with T2D and prediabetes risks. RESULTS: The multivariable-adjusted hazard ratios based on different levels of prepregnancy BMI (<23, 23-24.9, 25-29.9, and ≥30 kg/m(2) ) were 1.00, 1.77, 2.35, and 6.54 (Ptrend < 0.001) for incident T2D, and 1.00, 1.46, 1.87, and 1.79 (Ptrend < 0.001) for incident prediabetes, respectively. Compared with women with stable weight (±3 kg), those with weight gain ≥7 kg had an 86% and a 32% increased risk of diabetes and prediabetes, and those with weight loss ≥3 kg had a 45% decreased risk of prediabetes. The positive associations of prepregnancy BMI with incident diabetes and prediabetes risk were persistent in women with different levels of weight change (<3 kg and ≥3 kg). CONCLUSION: Prepregnancy obesity and excessive weight gain from prepregnancy to postpartum increase postpartum diabetes and prediabetes risks among GDM women.