title: Gestational weight gain in obese women by class of obesity and select maternal/newborn outcomes: A systematic review.
abstract: BACKGROUND
  Obesity and gestational weight gain impact maternal and fetal risks. Gestational weight gain guidelines are not stratified by severity of obesity.
  
  
  OBJECTIVE
  Conduct a systematic review of original research with sufficient information about gestational weight gain in obese women stratified by obesity class that could be compared to current Institute of Medicine guidelines. Evaluate variance in risk for selected outcomes of pregnancy with differing gestational weight gain in obese women by class of obesity.
  
  
  METHODS
  A keyword advanced search was conducted of English-language, peer-reviewed journal articles using 3 electronic databases, article reference lists and table of content notifications through January 2015. Data were synthesized to show changes in risk by prevalence.
  
  
  RESULTS
  Ten articles met inclusion criteria. Outcomes assessed were large for gestational age, small for gestational age, and cesarean delivery. Results represent nearly 740,000 obese women from four different countries. Findings consistently demonstrated gestational weight gain varies by obesity class and most obese women gain more than recommended by Institute of Medicine guidelines. Obese women are at low risk for small for gestational age and high risk for large for gestational age and risk varies with class of obesity and gestational weight gain. Research suggests the lowest combined risk of selected outcomes with weight gain of 5-9kg in women with class I obesity, 1 to less than 5kg for class II obesity and no gestational weight gain for women with class III obesity.
  
  
  CONCLUSIONS
  Gestational weight gain guidelines may need modification for severity of obesity.
authors: Baylor University-Louise Herrington School of Nursing, 3700 Worth Street, Dallas, TX 75246, USA. Electronic address: maryann_faucher@baylor.edu.
authors: Mary Ann
authors: MA
authors: Faucher
authors: Hahn School of Nursing, University of San Diego, 5998 Alcala Park, San Diego, CA 92110, USA. Electronic address: mbarger@sandiego.edu.
authors: Mary K
authors: MK
authors: Barger
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D009765:Obesity / Q000145:classification* / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000145:classification / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012306:Risk; D015430:Weight Gain
keywords: Gestational weight gain; Obesity; Pregnancy complications; Pregnancy outcomes; Weight gain