Predictors and consequences of weight retention in the early and late postpartum period in women with gestational diabetes.

AIMS We investigated the predictors and consequences of postpartum weight retention (PPWR) in the early and late postpartum period in women with gestational diabetes (GDM), to assist preventive strategies. METHODS 862 women with GDM between 2011 and 2019 were prospectively included. We investigated PPWR at 6-8 weeks (n= 862) and at 1-year (n=259) postpartum. Potential predictors included gestational weight gain (GWG), weight, BMI, and glucose control parameters during and after pregnancy. RESULTS Mean PPWR at 6-8 weeks and 1-year postpartum were 4.6±5.7kg and 4.0 ±7.4kg. The proportion of women with PPWR at 6-8 weeks and 1-year postpartum were 81% and 66.4% respectively. At 6-8 weeks postpartum, women with PPWR had higher pre-pregnancy weight, 7.5±0.2kg higher GWG and higher postpartum weight (all p≤0.02), without presenting metabolic differences. At 1-year postpartum, there were no differences in anthropometric parameters before and during pregnancy between women with or without PPWR, except for a 4±0.4kg higher GWG (p<0.001). However, women with PPWR had increased postpartum weight and BMI, higher fasting glucose and more pronounced increases in Δfasting glucose and ΔHbA1c at 1-year (all p≤0.03). GWG predicted higher PPWR at both 6-8 weeks and at 1-year PP (all p<0.001). CONCLUSION Women with PPWR had increased anthropometric parameters and adverse metabolic consequences at 1-year postpartum. GWG was the most relevant predictor of PPWR.