Pre-Pregnancy BMI and Weight Gain Linked to Higher Cesarean Delivery Risk, suggests study

Recent study focused on investigating the impact of pre-pregnancy BMI and changes in gestational weight gain (GWG) trajectories on cesarean section rates in women with gestational diabetes mellitus (GDM). The research was conducted in Taiwan with 947 participants diagnosed with GDM. The study classified GWG patterns into non-rapid excessive weight gain and rapid excessive weight gain groups, with the latter contributing significantly to cesarean section rates. Pre-pregnancy BMI played a crucial role, with normal and overweight/obese women having higher odds of cesarean sections. Multiparous women and those with rapid excessive weight gain trajectories were more likely to undergo cesarean delivery.

Importance of Educating Women on Weight Management

The findings emphasized the importance of educating women on weight management from pre-pregnancy through pregnancy to reduce cesarean section incidences. Specifically, women with GDM showing rapid excessive weight gain should receive particular attention to minimize the cesarean delivery risk. Gestational weight gain in the first trimester is associated with maternal fat, while weight gain in the second and third trimesters affects fetal growth. It was highlighted that excessive GWG poses a threat to birth outcomes, and that maintaining appropriate weight gain is crucial for avoiding adverse childbirth outcomes.

GWG Trajectories and Relationship with Cesarean Incidences

The study utilized group-based trajectory modeling to identify different GWG trajectories and their relationship with cesarean section incidences. The results indicated that excessive and rapid GWG was a high-risk factor for cesarean section, especially in underweight women before pregnancy. Additionally, the study discussed the physiological mechanisms linking excessive GWG, hyperglycemia, fetal hyperinsulinemia, and adverse birth outcomes. Recommendations included emphasizing pre-pregnancy weight management and gestational weight changes to reduce cesarean section rates in women with GDM.

Addressing Pre-pregnancy BMI and Monitoring GWG Trajectories

Overall, the study highlighted the importance of addressing pre-pregnancy BMI, monitoring GWG trajectories, and providing targeted interventions to prevent rapid and excessive weight gain during pregnancy, particularly in women with GDM. The findings contribute to understanding the relationship between GWG patterns and cesarean sections, emphasizing the need for tailored interventions to improve maternal and infant health outcomes.

Key Points

- The study aimed to assess the influence of pre-pregnancy BMI and variations in gestational weight gain (GWG) patterns on cesarean section rates in women diagnosed with gestational diabetes mellitus (GDM) in Taiwan, involving 947 participants.

- Two GWG trajectory groups were identified: non-rapid excessive weight gain and rapid excessive weight gain, with the latter demonstrating a significant association with increased cesarean section rates.

- Women with normal and overweight/obese pre-pregnancy BMIs were found to have higher chances of undergoing cesarean deliveries, especially if they were multiparous and had rapid excessive weight gain trajectories during pregnancy.

- Educating women on weight management is crucial throughout pre-pregnancy and pregnancy to mitigate the risk of cesarean sections, particularly for those with GDM exhibiting rapid excessive weight gain to reduce adverse birth outcomes.

- Excessive and rapid GWG, particularly in underweight women before pregnancy, was identified as a major risk factor for cesarean deliveries, with physiological mechanisms connecting excessive GWG, hyperglycemia, fetal hyperinsulinemia, and negative birth outcomes.

- The study emphasizes the significance of addressing pre-pregnancy BMI, tracking GWG trajectories, and offering tailored interventions to prevent excessive weight gain during pregnancy, with a specific focus on women with GDM to enhance maternal and infant health outcomes.

Reference –

Tzu-Ling Chen et al. (2025). Gestational Weight Gain Patterns As Predictors Of Cesarean Deliveries In Women Diagnosed With Gestational Diabetes Mellitus. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07222-x.