What history should alert the nurse to a pregnant client’s risk for developing gestational diabetes?

A history of having a baby that weighed 10 pounds at birth is a significant risk factor for developing gestational diabetes in subsequent pregnancies. This condition occurs when the body cannot produce enough insulin to meet the increased demands during pregnancy, leading to elevated blood sugar levels. Macrosomia, which refers to excessive birth weight, is often associated with maternal hyperglycemia, indicating that the mother may have had undiagnosed gestational diabetes or another issue that could predispose her to the condition in future pregnancies. Therefore, the previous experience of delivering a large baby highlights a concerning trend that requires careful monitoring during the current pregnancy for signs of gestational diabetes.

In contrast, factors like a previous birth with low birth weight, regular physical activity, or maintaining a balanced diet do not indicate an increased risk for developing gestational diabetes and, in fact, may suggest a healthier profile overall.