Obesity and Rapid Gestational Weight Gain Linked to Higher Cesarean Risk in Women with GDM: Study
A new study from northern Taiwan revealed a significant association between pre-pregnancy obesity, rapid gestational weight gain (GWG), and the increased likelihood of cesarean section deliveries among women diagnosed with gestational diabetes mellitus (GDM). The findings were published in the BMC Pregnancy and Childbirth.
The retrospective cohort study examined 947 women who delivered between January 2012 and July 2022 to assess the influence of body mass index (BMI) and changes in GWG trajectories from the first to the third trimester on cesarean section rates. This study utilized oral glucose tolerance tests (OGTT) during the 24th to 28th weeks of pregnancy to confirm GDM diagnoses. BMI classifications followed Asian-specific guidelines, and gestational weight patterns were identified using group-based trajectory modeling (GBTM).
The participants were divided into 2 groups based on their GWG patterns where group 1 (non-rapid excessive weight gain) made up 70.2% of the cohort, while group 2 (rapid excessive weight gain) comprised 29.8%. The study uncovered a relationship between rapid excessive weight gain during pregnancy and higher rates of cesarean deliveries.
Women with normal pre-pregnancy BMI had double the odds (OR = 2.06) of cesarean delivery when compared to their underweight counterparts. The patients categorized as overweight or obese faced an even greater risk, with four times the likelihood (OR = 4.04) of cesarean delivery. Also, women who had multiple pregnancies (multiparous) and the individuals experiencing a rapid increase in weight gain during pregnancy were more likely to undergo cesarean sections.
The findings illuminate the importance of early education and intervention for weight management in women both before and during pregnancy. The study emphasized that clinicians should pay special attention to women with GDM who exhibit rapid weight gain, as these individuals face an increased risk of cesarean delivery.
Effective monitoring of weight gain patterns across all three trimesters could help healthcare professionals better tailor recommendations for managing GDM and promoting safer delivery outcomes. Overall, this study adds valuable insight into the role of GWG and pre-pregnancy BMI in cesarean section risk.
Source:
Chen, T.-L., Cheng, S.-F., Kuo, C.-L., Huang, C.-Y., & Wu, C.-H. (2025). Gestational weight gain patterns as predictors of cesarean deliveries in women diagnosed with gestational diabetes mellitus. BMC Pregnancy and Childbirth, 25(1). https://doi.org/10.1186/s12884-025-07222-x
