Impact of Gestational Weight Gain on Perinatal Outcomes in Obese Women

Abstract

Objective This study aims to evaluate perinatal outcomes, according to gestational weight gain (GWG) in obese women.

Study Design A retrospective cohort of perinatal outcomes in obese women who gained below, within, or above the 2009 Institute of Medicine guidelines and delivered ≥ 36 weeks. Additionally, outcomes, according to the rate of GWG (kg/week; minimal [< 0.16], moderate [0.16–0.49], or excessive [> 0.49]) were compared among women delivering preterm.

Results Overall, 5,651 obese women delivered ≥ 36 weeks. GWG above guidelines was associated with increased cesarean section (adjusted odds ratio [aOR]: 1.44, 95% confidence interval [CI]: 1.21–1.72), gestational hypertension (aOR: 1.58, 95% CI: 1.21–2.06), and macrosomia (birth weight ≥ 4,000 g) (aOR: 2.08, 95% CI: 1.62–2.67). GWG below recommendations was associated with less large for gestational age infants (aOR: 0.60, 95% CI: 0.47–0.75). A total of 6,663 women delivered ≥ 20 weeks. Minimal weekly GWG was associated with increased spontaneous preterm birth (aOR: 1.56, 95% CI: 1.23–1.98) and more small for gestational age (SGA) infants (aOR: 1.55, 95% CI: 1.19–2.01). Excessive weekly GWG was associated with increased indicated preterm birth (aOR: 1.61, 95% CI: 1.29–2.01), cesarean section (aOR: 1.39, 95% CI: 1.20–1.61), preeclampsia (aOR: 1.83, 95% CI: 1.49–2.26), neonatal intensive care unit admission (aOR: 1.33, 95% CI: 1.08–1.63), and macrosomia (aOR: 2.40, 95% CI: 1.94–2.96).

Conclusions Obese women with excessive GWG had worse outcomes than women with GWG within recommendations. Limited GWG was associated with increased spontaneous preterm birth and SGA infants.

Keywords

obesity - gestational weight gain - IOM guidelines - perinatal outcomes

Note

This study was presented in part at the 33rd Annual Meeting of the Society of Maternal-Fetal Medicine; February 11–16, 2013; San Francisco, CA.

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