{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T01:55:38Z","timestamp":1778637338979,"version":"3.51.4"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,7,11]],"date-time":"2018-07-11T00:00:00Z","timestamp":1531267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2019,2]]},"abstract":"Abstract<\/jats:title>Aim<\/jats:title>Excessive gestational weight gain increases risk of gestational diabetes mellitus (GDM<\/jats:styled-content>) but it remains unclear whether weight control after GDM<\/jats:styled-content> diagnosis improves outcomes. We assessed whether: (1) total gestational weight gain during pregnancy (0\u201336 weeks); (2) early gestational weight gain (0\u201328 weeks, before GDM<\/jats:styled-content> diagnosis); or (3) late gestational weight gain (28\u201336 weeks, after diagnosis) are associated with maternal\u2013fetal outcomes.<\/jats:p><\/jats:sec>Methods<\/jats:title>Some 546 women with GDM<\/jats:styled-content> who delivered viable singleton infants at a single UK<\/jats:styled-content> obstetric centre (October 2014 to March 2017) were included in this retrospective observational study.<\/jats:p><\/jats:sec>Results<\/jats:title>Higher total gestational weight gain was associated with Caesarean section [n<\/jats:italic> = 376; odds ratio (OR<\/jats:styled-content>) 1.05; confidence intervals (CI<\/jats:styled-content>) 1.02\u20131.08, P<\/jats:italic> < 0.001] and large for gestational age (OR<\/jats:styled-content> 1.08; CI<\/jats:styled-content> 1.03\u20131.12, P<\/jats:italic> < 0.001). Higher late gestational weight gain (28\u201336 weeks; n<\/jats:italic> = 144) was associated with large for gestational age (OR<\/jats:styled-content> 1.17; CI<\/jats:styled-content> 1.01\u20131.37, P<\/jats:italic> < 0.05), instrumental deliveries (OR<\/jats:styled-content> 1.26; CI<\/jats:styled-content> 1.03\u20131.55, P<\/jats:italic> < 0.01), higher total daily insulin doses (36 weeks; beta coefficient 4.37; CI<\/jats:styled-content> 1.92\u20136.82, P<\/jats:italic> < 0.001), and higher post\u2010partum 2\u2010h oral glucose tolerance test concentrations (beta coefficient 0.12; CI<\/jats:styled-content> 0.01\u20130.22, P<\/jats:italic> < 0.05). Women who avoided substantial weight gain after GDM<\/jats:styled-content> diagnosis had 0.7 mmol\/l lower postnatal 2\u2010h glucose and needed half the amount of insulin\/day at 36 weeks compared with women with substantial weight gain after diagnosis. There were no significant associations between early gestational weight gain (0\u201328 weeks) and pregnancy outcomes.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>These findings suggest that controlling gestational weight gain should be a priority following GDM<\/jats:styled-content> diagnosis to optimize pregnancy outcomes and improve maternal postnatal glucose homeostasis. The period after diagnosis of GDM<\/jats:styled-content> (often 28 weeks gestation) is not too late to offer lifestyle advice or intervention to improve weight management and pregnancy outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.13767","type":"journal-article","created":{"date-parts":[[2018,6,22]],"date-time":"2018-06-22T10:46:02Z","timestamp":1529664362000},"page":"167-176","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Improving outcomes in gestational diabetes: does gestational weight gain matter?"],"prefix":"10.1111","volume":"36","author":[{"given":"C. E. M.","family":"Aiken","sequence":"first","affiliation":[{"name":"Department of Obstetrics Cambridge University Hospitals Rosie Hospital Cambridge UK"},{"name":"University of Cambridge Cambridge UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7159-7321","authenticated-orcid":false,"given":"L.","family":"Hone","sequence":"additional","affiliation":[{"name":"University of Cambridge Cambridge UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6876-8727","authenticated-orcid":false,"given":"H. R.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Wolfson Diabetes and Endocrinology Clinic Cambridge UK"},{"name":"Norwich Medical School University of East Anglia Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4176-8329","authenticated-orcid":false,"given":"C. 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