Background: Since the implementation of China’s new birth policy, the incidence of large for gestational age (LGA) and macrosomia associated with gestational diabetes mellitus (GDM) has increased. It remains unclear whether a history of GDM in a previous pregnancy raises the risk of LGA or macrosomia in Chinese women planning two or more pregnancies.Aim: To analyze the association between previous GDM and the risk of LGA and macrosomia in second pregnancy.Method: A retrospective study was conducted on a cohort of 3,131 women who had experienced two consecutive singleton births. The incidences of LGA and macrosomia in the second pregnancy were compared between women with and without previous GDM. The relationship between previous GDM and the occurrence of LGA and macrosomia was analyzed using multivariate logistic regression and stratified analysis.Results: The incidence of LGA and macrosomia during the second pregnancy was significantly higher in women with previous GDM (22.67% and 10.25%, respectively) compared to those without prior GDM (15.34% and 5.06%, respectively) (P < 0.05). After adjusting for potential confounders, previous GDM was significantly associated with LGA (aOR: 1.511, 95% CI: 1.066-2.143) and macrosomia (aOR: 1.854, 95% CI: 1.118-3.076) in the second pregnancy. Stratified analysis revealed that these associations were present only in women without previous LGA, those with GDM, appropriate gestational weight gain (AGWG), non-advanced maternal age, and male newborns during the second pregnancy (P < 0.05). Compared to excessive GWG (EGWG), AGWG correlated with lower risks for LGA and macrosomia during the second pregnancy in women without prior GDM, an association not observed in those with previous GDM. Among women without previous GDM, if the pre-pregnancy BMI is normal, the risk of LGA and macrosomia is significant lower in AGWG compared with EGWG (P< 0.001), while this difference was no significant among women with prior GDM (P>0.05).Conclusion: Previous GDM is strongly linked to LGA and macrosomia in subsequent pregnancies. However, this relationship is influenced by GWG, prior LGA history, fetal sex, and maternal age. Managing weight alone may not sufficiently reduce the risk of LGA or macrosomia for women with a history of GDM.

Interpregnancy interval (IPI) is associated with the risk of GDM in a second pregnancy. However, an optimal IPI is still need to be determined based on the characteristics of the population. This study aimed to analyze the effect of interpregnancy interval (IPI) on the risk of gestational diabetes mellitus (GDM) in the Chinese population. We conducted a retrospective cohort study on female participants who had consecutive deliveries at Peking University Shenzhen Hospital from 2013 to 2021. The IPI was categorized into 7 groups and included into the multivariate logistic regression model with other confound factors. Analysis was also stratified based on age of first pregnancy, BMI, and history of GDM. Adjusted OR values (aOR) and 95% confidence intervals (CI) calculated. The regression coefficient of IPI months on GDM prediction risk was analyzed using a linear regression model. A total of 2,392 participants were enrolled. The IPI of the GDM group was significantly greater than that of the non-GDM group (P < 0.05). Compared with the 18–24 months IPI category, participants with longer IPIs (24–36 months, 36–48 months, 48–60 months, and ≥ 60 months) had a higher risk of GDM (aOR:1.585, 2.381, 2.488, and 2.565; 95% CI: 1.021–2.462, 1.489–3.809, 1.441–4.298, and 1.294–5.087, respectively). For participants aged < 30 years or ≥ 30 years or without GDM history, all longer IPIs (≥ 36 months) were all significantly associated with the GDM risk in the second pregnancy (P < 0.05), while any shorter IPIs (< 18 months) was not significantly associated with GDM risk (P > 0.05). For participants with GDM history, IPI 12–18 months, 24–36 months, 36–48 months, and ≥ 60 months were all significantly associated with the GDM risk (aOR: 2.619, 3.747, 4.356, and 5.373; 95% CI: 1.074–6.386, 1.652–8.499, 1.724–11.005, and 1.078–26.793, respectively), and the slope value of linear regression (0.5161) was significantly higher compared to participants without a history of GDM (0.1891) (F = 284.168, P < 0.001). Long IPI increases the risk of GDM in a second pregnancy, but this risk is independent of maternal age. The risk of developing GDM in a second pregnancy for women with GDM history is more significantly affected by IPI.

Objectives This study aimed to investigate the impact of interpregnancy weight changes (IPWC) on the gestational diabetes mellitus (GDM) in the second pregnancy. Design A single-centre retrospective cohort study was conducted in China. Setting Data were collected in Peking University Shenzhen Hospital from 2013 January to 2021 February. Participants Participants include women who had two consecutive singleton deliveries after 28 gestational weeks (n=2372). Outcomes The GDM in the second pregnancy (s-GDM) was set as the outcome. Methods IPWC was defined as the change in body mass index between the first trimester of the second pregnancy and that of the first pregnancy, categorised into four groups with −1 kg/m² to <1 kg/m² as the reference. Adjusted ORs (aORs) with 95% CIs attained from multivariable logistic regression were used to assess the association between IPWC and s-GDM, in both total subjects and stratified subgroups. Results In the overall analysis, s-GDM was found to be significantly associated with IPWC value (aOR 1.111; 95% CI 1.038 to 1.190) and an IPWC category of ≥3 kg/m² (aOR 1.821; 95% CI 1.197 to 2.772). In the stratified analysis, the significant association between IPWC ≥3 kg/m² and s-GDM was evident only in the subgroups of an interpregnancy interval (IPI) of less than 36 months (aOR 2.210, 95% CI 1.251 to 3.904), under the age of 35 (aOR 1.854, 95% CI 1.204 to 2.857), non-diabetic status in the first pregnancy (f-ND) (aOR 1.872, 95% CI 1.143 to 3.065) and those with normal weight in the first pregnancy (aOR 1.936, 95% CI 1.174 to 3.193). The significant association between IPWC value and s-GDM was also shown only in these subgroups (p<0.05). In f-DN subgroup, even an IPWC category of 1 kg/m² to <3 kg/m² was significantly associated with s-GDM (aOR 1.486, 95% CI 1.044 to 2.117). IPWC < −1 kg/m² was not significantly associated with s-GDM either in the overall analysis or in the stratified analysis (p>0.05). Conclusion An IPWC of 3 kg/m² or higher may increase the risk of s-GDM, particularly among women with an IPI of less than 36 months, those under 35 years old, individuals without diabetes, or those with normal weight during their first pregnancy. The potential influence of prior GDM on the relationship between IPWC and s-GDM warrants further investigation.

Background: While prior macrosomia has been linked to subsequent gestational diabetes mellitus (GDM), the association between a history of large-for-gestational-age (LGA) births and subsequent GDM, as well as its comparative relevance versus macrosomia, remain underexplored in Chinese populations, highlighting a critical gap in perinatal risk stratification. Aim: To determine whether a history of LGA (f-LGA) birth is independently associated with subsequent GDM (s-GDM) and compare its associative relevance versus macrosomia in Chinese multiparous women. Method: This retrospective cohort study included women with consecutive singleton deliveries (2002-2024) at Peking University Shenzhen Hospital. Exposures were LGA (birth weight ≥90th percentile, China 2020 standards) or macrosomia (≥4000 g) in the first pregnancy; outcome was s-GDM (IADPSG criteria). Associations were evaluated using restricted cubic splines (RCS) and multivariable logistic regression with sequential adjustment (unadjusted, minimally adjusted, and fully adjusted). Stratified analyses assessed effect modification by prior GDM, maternal age, and pre-pregnancy BMI in the first pregnancy. Results: Among 3,110 women analyzed, RCS analyses revealed a significant monotonic increase in s-GDM risk with higher birth weight percentiles (P for association < 0.001, P for nonlinearity = 0.010 after full adjustment). Although absolute birth weight categories showed a statistically significant overall association (P for association = 0.033), no dose-response pattern was observed. After full adjustment, prior LGA remained significantly associated with s-GDM (aOR = 1.458, 95% CI: 1.045–2.035), whereas prior macrosomia did not (aOR = 1.271, 95% CI: 0.782–2.067). Significant positive trends existed across percentile categories ( P for trend = 0.025) but not absolute weight categories ( P for trend = 0.310). Stratified analyses demonstrated robust associations of f-LGA with s-GDM specifically in women without prior GDM (aOR = 1.544, 95% CI: 1.069–2.232), aged <35 years (aOR=1.668, 95% CI: 1.095–2.542), and with normal pre-pregnancy BMI (aOR=1.757, 95% CI: 1.169–2.641) ( P for trend < 0.001 for all strata). Conclusion: A history of LGA birth is independently associated with s-GDM risk in Chinese multiparous women, particularly among those without prior dysglycemia, aged <35 years, or with normal BMI. The percentile-defined LGA definition demonstrates superior associative relevance compared to absolute macrosomia, supporting its application in precision screening for multiparous pregnancies.

Anaphylaxis during pregnancy is common, but severe anaphylaxis during pregnancy is relatively rare and may have serious implications for both the mother and the fetus, potentially leading to maternal death or neonatal death. Anaphylaxis caused by iodophor skin disinfection is commonly observed, but there has been no reported case of severe anaphylaxis occurring during pregnancy when iodophor is used for vaginal douche. Our case report suggests that pregnant women should be cautious about the potential risk of severe anaphylaxis when using iodophor vaginally and highlights the importance of managing severe allergic reactions in pregnancy.

Purpose This study aimed to analyze the effect of interpregnancy interval (IPI) on the risk of gestational diabetes mellitus (GDM) in the Chinese population. Methods Female participants who had consecutive singleton deliveries in Peking University Shenzhen Hospital from 2013 to 2021 were selected for this retrospective cohort study. They were divided into GDM and non-GDM groups according to whether GDM was a complication in the second pregnancy. IPI and other possible GDM risk factors in the second pregnancy were assayed by univariate and multivariate logistic regression analysis. Results A total of 2,392 female participants were enrolled. The IPI of the GDM group was significantly greater than that of the non-GDM group (P < 0.05). Compared with the 18–23 months IPI category, participants with longer IPIs (24–35 months, 36–47 months, 48–59 months, and ≥60 months) had a higher risk of GDM (aOR:1.590, 2.390, 2.493, and 2.581; 95% CI: 1.026–2.464, 1.498–3.814, 1.447–4.297, and 1.303–5.109, respectively). The GDM risk was not significantly changed in participants with shorter IPIs (12–17 months, 18–23 months; P﹥0.05). A model consisting of IPI, maternal age, body mass index, and previous GDM manifested the best discrimination for GDM in the second pregnancy [AUC = 0.758 (95% CI: 0.728–0.788), P < 0.001]. For participants aged <35 years or without previous GDM, the risk of GDM significantly increased when the IPI was ≥36 months. The minimum IPI for a significant increase in GDM risk was 24–35 months in the participants with previous GDM. Conclusions An IPI longer than 24 months was associated with an increased GDM risk. The risk of GDM in a second pregnancy for women with previous GDM was more significantly affected by the IPI.