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Am J Perinatol 2016; 33(09): 849-855
DOI: 10.1055/s-0036-1579650
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Impact of Gestational Weight Gain on Perinatal Outcomes in Obese Women

Jennifer K. Durst
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Alabama, Birmingham, Alabama
2   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
,
Amelia L. M. Sutton
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Alabama, Birmingham, Alabama
,
Suzanne P. Cliver
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Alabama, Birmingham, Alabama
,
Alan T. Tita
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Alabama, Birmingham, Alabama
,
Joseph R. Biggio
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Alabama, Birmingham, Alabama
› Author Affiliations
Further Information

Publication History

14 January 2016

22 January 2016

Publication Date:
09 March 2016 (online)

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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.