Abstract：[Abstract]Objective To investigate the effect of pre-pregnancy body mass index（BMI）and weight changes during pregnancy on pregnancy outcomes in pregnant women with gestational diabetes mellitus（GDM）.Methods A total of 242 pregnant women with GDM who were admitted and delivered in our hospital from March 2016 to April 2018 were enrolled as subjects.According to the pre-pregnancy BMI，the pregnant women were divided into underweight group（n=39），standard-weight group（n=158），overweight-obese group（n=45）.In addition，according to the weight gain during pregnancy，all the participants were divided into insufficient weight gain group（n=22），normal weight gain group（n=90），excess weight gain group（n=130）.The blood glucose level，delivery mode and pregnancy outcomes of the 242 pregnant women were recorded.Results Fasting blood glucose and 1-hour postprandial blood glucose in the overweight-obese group were higher than those in the underweight group and standard-weight group，with statistically significant differences（P＜0.05）.The fasting blood glucose in the standard-weight group was higher than that in the underweight group，with statistically significant difference（P＜0.05）.There were statistically significant differences in the incidence rates of cesarean section，giant infants，low-birth-weight infants，neonatal asphyxia，fetal distress，postpartum hemorrhage and preterm birth in the overweight-obese group，standard-weight group，and underweight group（P＜0.05）.There were statistically significant differences in the incidence rates of cesarean section，giant infants，low-birth-weight infants，neonatal asphyxia，fetal distress，postpartum hemorrhage and preterm birth in the insufficient weight gain group，normal weight gain group，and excess weight gain group（P＜0.05）.Conclusion Pre-pregnancy BMI can affect the blood glucose level of pregnant women during GDM，especially in fasting blood glucose and 1-hour postprandial blood glucose.The influencing factors of GDM pregnant women′s pregnancy outcome might be pre-pregnancy BMI and pregnancy weight gain.Pregnant women with GDM should pay attention to reasonable weight management during pregnancy.
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