title: Pregnancy outcomes with weight gain above or below the 2009 Institute of Medicine guidelines.
abstract: OBJECTIVE
  To evaluate pregnancy outcomes according to 2009 Institute of Medicine (IOM) gestational weight gain guidelines.
  
  
  METHODS
  This study is a secondary analysis of a preeclampsia prevention trial among nulliparas carrying singletons. Odds ratios and 95% confidence intervals (adjusted for maternal age, race, smoking, and treatment group) were calculated based on total weight gain below or above the IOM guidelines stratified by prepregnancy body mass index (BMI). The referent group was weight gain within the guidelines.
  
  
  RESULTS
  Of 8,293 pregnancies, 9.5% had weight gain below, 17.5% within, and 73% above IOM guidelines. With excess weight gain, all BMI categories had an increased risk of hypertensive disorders; normal weight and overweight women also had increased risk of cesarean delivery and neonatal birth weight at or above the 90 centile but a decreased risk of weight below the 10 centile. There were no consistent associations with insufficient weight gain and adverse outcomes.
  
  
  CONCLUSIONS
  Excess weight gain was prevalent and associated with an increased risk of hypertensive disorders, cesarean delivery, and large-for-gestational-age neonates.
authors: Departments of Obstetrics and Gynecology, Brown University, Providence, Rhode Island, the University of Pittsburgh, Pittsburgh, Pennsylvania, the University of Cincinnati, Cincinnati, Ohio, the University of Alabama at Birmingham, Birmingham, Alabama, the University of Utah, Salt Lake City, Utah, Columbia University, New York, New York, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio, Northwestern University, Chicago, Illinois, the University of Texas Health Science Center at Houston, Houston, Texas, The Ohio State University, Columbus, Ohio, Drexel University, Philadelphia, Pennsylvania, Wake Forest University Health Sciences, Winston-Salem, North Carolina, Oregon Health & Science University, Portland, Oregon, University of Texas Medical Branch, Galveston, Texas, and Wayne State University, Detroit, Michigan; the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
authors: Julie
authors: J
authors: Johnson
authors: Rebecca G
authors: RG
authors: Clifton
authors: James M
authors: JM
authors: Roberts
authors: Leslie
authors: L
authors: Myatt
authors: John C
authors: JC
authors: Hauth
authors: Catherine Y
authors: CY
authors: Spong
authors: Michael W
authors: MW
authors: Varner
authors: Ronald J
authors: RJ
authors: Wapner
authors: John M
authors: JM
authors: Thorp
authors: Brian M
authors: BM
authors: Mercer
authors: Alan M
authors: AM
authors: Peaceman
authors: Susan M
authors: SM
authors: Ramin
authors: Philip
authors: P
authors: Samuels
authors: Anthony
authors: A
authors: Sciscione
authors: Margaret
authors: M
authors: Harper
authors: Jorge E
authors: JE
authors: Tolosa
authors: George
authors: G
authors: Saade
authors: Yoram
authors: Y
authors: Sorokin
mesh_terms: D001835:Body Weight; D005260:Female; D006801:Humans; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D015430:Weight Gain; D055815:Young Adult
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