title: Excessive weight gain among obese women and pregnancy outcomes.
abstract: We evaluated pregnancy outcomes in obese women with excessive weight gain during pregnancy. A retrospective study was performed on all obese women. Outcomes included rates of preeclampsia (PEC), gestational diabetes, cesarean delivery (CD), preterm delivery, low birth weight, very low birth weight, macrosomia, 5-minute Apgar score of <7, and neonatal intensive care unit (NICU) admission and were stratified by body mass index (BMI) groups class I (BMI 30 to 35.9 kg/m(2)), class II (36 to 39.9 kg/m(2)), and class III (>or=40 kg/m(2)). Gestational weight change was abstracted from the mother's medical chart and was divided into four categories: weight loss, weight gain of up to 14.9 pounds, weight gain of 15 to 24.9 pounds, and weight gain of more than 25 pounds. A total 20,823 obese women were eligible for the study. Univariate analysis revealed higher rates of preeclampsia, gestational diabetes, Cesarean deliveries, preterm deliveries, low birth weight, macrosomia, and NICU admission in class II and class III obese women when compared with class I women. When different patterns of weight gain were used as in the logistic regression model, rates of PEC and CD were increased. Excessive weight gain among obese women is associated with adverse outcomes with a higher risk as BMI increases.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Miller University of Miami School of Medicine, Miami, Florida 33101, USA.
authors.forename: Amy A
authors.initials: AA
authors.lastname: Flick
authors.forename: Kathleen F
authors.initials: KF
authors.lastname: Brookfield
authors.forename: Lesley
authors.initials: L
authors.lastname: de la Torre
authors.forename: Carmen Maria
authors.initials: CM
authors.lastname: Tudela
authors.forename: Lunthita
authors.initials: L
authors.lastname: Duthely
authors.forename: Víctor Hugo
authors.initials: VH
authors.lastname: González-Quintero
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D016001:Confidence Intervals; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D009765:Obesity / Q000150:complications / Q000175:diagnosis*; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D015430:Weight Gain