Objective To identify the ranges of gestational weight gain for Chinese women with gestational diabetes based on the different pre-pregnancy body mass index group, and to investigate the association between gestational weight gain and maternal-infant adverse outcomes. Design A single-center retrospective cohort study. Setting A tertiary public women's and children's hospital in China. Population Women with gestational diabetes. Methods Retrospective analysis of 17,216 women with gestational diabetes who delivered singleton, registered between 2013 and 2018. Main outcome measures Gestational weight gain ranges, maternal-infant adverse outcomes. Results A total of 14,517 women were included finally. In comparison to the recommended gestational weight gain ranges by the National Academy of Medicine, the Chinese women with gestational diabetes in this study had a wider weight gain ranges, and faster rate of gestational weight gain. The risk of adverse outcomes increased steadily with gestational weight gain in the four body mass index groups. The ranges of gestational weight gain that were associated with lower risks of maternal-infant adverse outcomes were 15-20kg, 14-18kg, 4-8kg, and 0-4kg for the underweight, normal weight, overweight and obese groups, respectively. Conclusions The findings from this study can be used as a guideline for Chinese women with gestational diabetes. Healthcare professionals should provide targeted advice to women based on their pre-pregnancy body mass index to reduce the risks of maternal-infant adverse outcomes. Future high-quality and multi-center prospective studies are needed to validate our findings. Keywords Gestational weight gain, body mass index, gestational diabetes mellitus, maternal-infant adverse outcomes

Background: There is a lack of systematic review exploring the effectiveness of Enhanced Recovery After Surgery (ERAS) in hysterectomy in promoting better recovery. Objectives: To synthesize the best available evidence of the effectiveness of ERAS intervention in promoting better recovery of shortened length of hospital stay (primary outcome), lower readmission, and complication rates (secondary outcomes) among patients undergoing hysterectomy due to benign conditions as compared to conventional perioperative care. Search Strategy: Seven electronic databases were searched from the date of inception to December 2020. Selection Criteria: Randomized controlled trials, cohort studies, or quasi-experimental studies published in English examining the effects of ERAS for women diagnosed with benign gynecologic diseases and underwent either abdominal or laparoscopic hysterectomy were included. Data Collection and Analysis: Two reviewers independently conducted database search, data extraction, and methodological quality assessment. Meta-analyses were performed for all outcomes. The overall quality of evidence was assessed using GRADE. Main Results: Nine studies were included in this review. Meta-analysis showed a statistically significant reduction in length of hospital stay (SMD = -0.76, 95% CI [-1.06, -0.46], Z = 4.72, p < .00001), readmission rate (RR = 0.65, 95% CI [0.44-0.96]; Z = 2.16, p = .03) and complication rate (RR = 0.61, 95% CI [0.48-0.77]; Z = 4.17, p < .0001), with high certainty of evidence. Conclusions: The effectiveness of ERAS in improving recovery indicates that hospitals could adopt the protocol to improve patients’ health and wellbeing. Future studies can focus more on standardizing the protocol’s elements.