Am J Perinatol 2009; 26(5): 365-371
DOI: 10.1055/s-0028-1110088
© Thieme Medical Publishers

The Effects of Obesity and Weight Gain in Young Women on Obstetric Outcomes

Urania Magriples1 , Trace S. Kershaw2 , Sharon Schindler Rising3 , Claire Westdahl4 , Jeannette R. Ickovics2
  • 1Yale University School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, New Haven, Connecticut
  • 2Yale University School of Public Health, New Haven, Connecticut
  • 3Centering Healthcare Institute, Cheshire, Connecticut
  • 4Emory University School of Medicine, Department of Obstetrics and Gynecology, Atlanta, Georgia
Further Information

Publication History

Publication Date:
11 December 2008 (online)

ABSTRACT

We investigated body mass index (BMI) and weight gain among pregnant women (ages 14 to 25) and assessed the relationship of BMI and weight gain on birth outcomes. We performed a secondary analysis of 841 women enrolled in a randomized controlled trial receiving prenatal care in two university-affiliated clinics. Almost half the patients were overweight or obese. An average of 32.3 ± 23.6 pounds was gained in pregnancy with only 25.3% gaining the recommended weight and over half overgaining. Weight gain had a significant relationship to birth weight. Multivariate analysis showed that prepregnancy BMI but not weight gain was a significant predictor of cesarean delivery (odds ratio [OR] 1.91, confidence interval [CI] 1.24 to 2.69, p < 0.0001). When large-for-gestational-age infants were removed from the analysis, there was still a significant effect of BMI on cesarean delivery (OR 1.76, CI 1.17 to 2.66, p = 0.007) but not of weight gain (OR 1.45, CI 0.94 to 2.17, p = 0.093). Prepregnancy BMI is a more significant predictor of cesarean delivery than pregnancy weight gain in young women.

REFERENCES

  • 1 Ogden C L, Flegal K M, Carroll M D, Johnson C L. Prevalence and trends in overweight among U.S. children and adolescents, 1999–2000.  JAMA. 2002;  288 1728-1732
  • 2 Hedley A A, Ogden C L, Johnson C L, Carroll M D, Curtin L R, Flegal K M. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002.  JAMA. 2004;  291 2847-2850
  • 3 Hall L F, Neubert A G. Obesity and pregnancy.  Obstet Gynecol Surv. 2005;  60 253-260
  • 4 ACOG Committee Opinion on Obstetric Practice . Obesity in pregnancy.  Obstet Gynecol. 2005;  106 671-675
  • 5 Weiss J L, Malone F D, Emig D et al.. Obesity, obstetric complication and cesarean delivery rate: a population-based screening study.  Am J Obstet Gynecol. 2004;  190 1091-1097
  • 6 Pathi A, Esen U, Hildreth A. A comparison of complications of pregnancy and delivery in morbidly obese and non-obese women.  J Obstet Gynaecol. 2006;  26 527-530
  • 7 Kiel D W, Dodson E A, Artal R, Boehmer T, Leet T L. Gestational weight gain and pregnancy outcomes in obese women. How much is enough?.  Obstet Gynecol. 2007;  110 752-758
  • 8 Barau G, Robillard P Y, Hulsey T C et al.. Linear association between maternal pre-pregnancy body mass index and risk of caesarean section in term deliveries.  BJOG. 2006;  113 1173-1177
  • 9 Stotland N E, Hopkins L M, Caughey A B. Gestational weight gain, macrosomia and risk of Cesarean birth in nondiabetic nulliparas.  Obstet Gynecol. 2004;  104 671-677
  • 10 Sukalich S, Mingione M J, Glantz J C. Obstetrical outcomes in overweight and obese adolescents.  Am J Obstet Gynecol. 2006;  195 851-855
  • 11 Ickovics J R, Kershaw T S, Westdahl C et al.. Group prenatal care and perinatal outcomes: a randomized controlled trial.  Obstet Gynecol. 2007;  110 330-339
  • 12 Subcommittee on Nutritional Status and Weight Gain in Pregnancy, Institute of Medicine .Nutrition during Pregnancy. Washington DC; National Academy Press 2000
  • 13 Battaglia F C, Lubchenco L O. A practical classification of newborn infants by weight and gestational age.  J Pediatr. 1967;  71 159-163
  • 14 Hediger M L, Scholl T O, Ances I G, Belsky D H, Salmon R W. Rate and amount of weight gain during adolescent pregnancy: associations with maternal weight-for-height and birth weight.  Am J Clin Nutr. 1990;  52 793-799
  • 15 Stevens-Simon C, McAnarney E R, Roghmann K J. Adolescent gestational weight gain and birth weight.  Pediatrics. 1993;  92 805-809
  • 16 Johnston C S, Christopher F S, Kandell L A. Pregnancy weight gain in adolescents and young adults.  J Am Coll Nutr. 1991;  10 185-189

Urania MagriplesM.D. 

Department of Obstetrics, Yale University

333 Cedar Street, New Haven, CT 06520-8034

Email: urania.magriples@yale.edu

    >