title: The influence of gestational weight gain on the development of gestational hypertension in obese women.
abstract: OBJECTIVE
  The objective of this study was to examine the influence of gestational weight gain on the development of gestational hypertension/preeclampsia (GHTN/PE) in women with an obese prepregnancy body mass index (BMI).
  
  
  METHODS
  Obese women with a singleton pregnancy enrolled at < 20 weeks were studied. Data were classified according to reported gestational weight gain (losing weight, under-gaining, within target, and over-gaining) from the recommended range of 11 to 9.7 kg and by obesity class (class 1 = BMI 30-34.9 kg/m(2), class 2 = 35-39.9 kg/m(2), class 3 = 40-49.9 kg/m(2), and class 4 ≥ 50 kg/m(2)). Rates of GHTN/PE were compared by weight gain group overall and within obesity class using Pearson chi-square statistics.
  
  
  RESULTS
  For the 27,898 obese women studied, rates of GHTN/PE increased with increasing class of obesity (15.2% for class 1 and 32.0% for class 4). The incidence of GHTN/PE in obese women was not modified with weight loss or weight gain below recommended levels. Overall for obese women, over-gaining weight was associated with higher rates of GHTN/PE compared with those with a target rate for obesity classes 1 to 3 (each p < 0.001).
  
  
  CONCLUSIONS
  Below recommended gestational weight gain did not reduce the risk for GHTN/PE in women with an obese prepregnancy BMI. These data support a gestational weight gain goal ≤ 9.7 kg in obese gravidas.
authors.affiliation: Perinatal Diagnostic Center, Baptist Health Lexington, Lexington, Kentucky.
authors.forename: John R
authors.initials: JR
authors.lastname: Barton
authors.affiliation: Department of Maternal-Fetal Medicine, Carolinas Medical Center, Charlotte, North Carolina.
authors.forename: Saju D
authors.initials: SD
authors.lastname: Joy
authors.affiliation: Department of Clinical Research, Alere Women's and Children's Health, Atlanta, Georgia.
authors.forename: Debbie J
authors.initials: DJ
authors.lastname: Rhea
authors.affiliation: College of Charleston, Charleston, South Carolina.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Sibai
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Medical School at Houston, Houston, Texas.
authors.forename: Baha M
authors.initials: BM
authors.lastname: Sibai
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology*; D015994:Incidence; D009765:Obesity / Q000453:epidemiology*; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D014481:United States / Q000453:epidemiology; D015430:Weight Gain; D055815:Young Adult