Best practice is to always drive ADC inputs with an op-amp.
If, hypothetically, a person were to be the kind of dare-devil hacker as to disregard that rule of thumb and (gasp!) directly connect the ADXL193 +/-250g output to a 10 bit ratiometric ADC, then yes,
an ADC value of 30 counts above the "resting" value implies an acceleration of
30 * 5V/2^10 * 1g/8mV = 18 g.
Since the accelerometer is ratiometric and balances zero g near VCC/2, and assuming your ADC is also ratiometric, then after you drop your power supply voltage to 3.7 V,
the "resting" value you read on your ADC should be roughly the same as before,
and an 18 g acceleration will still produce the same 30 counts above the new resting value.
However, as Lou pointed out, you're likely to get a worse signal/noise ratio with VCC at 3.7 V than with VCC at 5 V.
However, if you were to follow recommended practice and stick an op-amp between the accelerometer and the ADC, the picture would be slightly different.
You have to pick some gain for the op-amp.
I suppose you could pick a gain of 1, which would give you the same numbers as above, but there are better choices for the gain.
I would try to spread the entire range of expected g forces, plus some safety margin ("fudge factor") at the top and bottom of the range, over the ADC input range.
Lou assumes that you pick a gain such that the full-range output of the accelerometer exactly matches the full-range input of your ADC.
That's a reasonable choice.
However, I would probably sacrifice some of that range to get more precision.
The kinds of accelerations I'm interested in are much smaller -- roller coasters and other amusement rides, hand-held tilt and shake and drop sensors, etc.
I've been told that highly-trained fighter pilots wearing anti-G suits black out around 9 g, so amusement rides will have much lower g forces.
I'm guessing around roughly +- 20 g is far more than enough.
To get +-20 g to map to the 0 to 5 V range of the ADC, I need a gain of
Again = 5 V * 1/40g * 1g/8mV = 16.
We'll probably round this to some convenient hardware value, and fix up the exact ratio in software.
With an op amp between the accelerometer an the ADC,
an ADC value of 30 counts above the "resting" value implies an acceleration of
30 * 5V/2^10 * 1/Again * 1G/8mV.
With the gain I've chosen, those 30 counts represent
30 * 5V/2^10 * 1/16 * 1g/8mV = 1.1 g.
This additional gain gives me an order of magnitude more resolution (I can distinguish between several different small accelerations that would have previously all been lumped into "zero acceleration), at the sacrifice of an order of magnitude of range.
Using an op-amp will definitely give you a better signal/noise ratio than no op amp at all. Using a gain of 10 or 30 or 100 may also give you a slightly better signal/noise ratio than a 1:1 op-amp.