Which factor in a pregnant client's history indicates a risk for developing gestational diabetes?

A key risk factor for developing gestational diabetes is having a history of delivering a larger baby, specifically a birth weight of 10 pounds or more. This condition, known as macrosomia, can be indicative of insulin resistance or glucose intolerance, both of which are central to the development of gestational diabetes during pregnancy. The presence of this history suggests that the client may have had issues with glucose metabolism in previous pregnancies, increasing the likelihood of similar issues recurring.

In contrast, factors like a BMI under 25, a history of uncomplicated pregnancies, or current regular exercise typically do not indicate an increased risk for gestational diabetes. A lower BMI is generally associated with a lower risk of various pregnancy complications. Uncomplicated pregnancies, when assessed alone, do not signal an increased risk for gestational diabetes without additional risk factors. Additionally, regular exercise is associated with better glucose metabolism and helps in managing weight gain, which lowers the risk of gestational diabetes. Therefore, the client's prior experience with a larger baby effectively raises the concern for gestational diabetes risk in their current pregnancy.