title: The impact of inadequate gestational weight gain in obese diabetic women.
abstract: OBJECTIVE
  To determine the effect of inadequate gestational weight gain (GWG) on neonatal birth weight in diabetic obese women.
  
  
  METHODS
  Retrospective cohort study of women with an initial body mass index (BMI) ⩾30 kg m(-2) and gestational or type 2 diabetes was conducted. GWG was stratified: inadequate (<11 lbs), adequate (11 to 20 lbs) or excessive (>20 lbs). The primary outcome was birth weight. Secondary outcomes included hypertensive disorders, gestational age at delivery, mode of delivery and Apgar scores.
  
  
  RESULTS
  A total of 211 obese diabetic women were identified. Of those, 37% had inadequate GWG, 25% had adequate GWG and 38% had excessive GWG. Women with inadequate GWG had lower mean birth weights (P=0.048), as well as lower rates of cesarean delivery (P=0.017) and lower rates of pregnancy-related hypertensive disorders (P=0.026) compared with those with adequate and excessive GWG.
  
  
  CONCLUSIONS
  Inadequate GWG was associated lower mean birth weights, lower rates of cesarean delivery and lower rates of pregnancy-related hypertensive disorders.
authors.affiliation: Department of Reproductive Medicine, University of California San Diego, San Diego, CA, USA.
authors.forename: K C
authors.initials: KC
authors.lastname: Kurnit
authors.affiliation: Department of Reproductive Medicine, University of California San Diego, San Diego, CA, USA.|Division of Maternal-Fetal Medicine, Department of Obsteterics and Gynecology, MedStar Washington Hospital Center, Washington, DC, USA.
authors.forename: R T
authors.initials: RT
authors.lastname: Overcash
authors.affiliation: Department of Reproductive Medicine, University of California San Diego, San Diego, CA, USA.
authors.forename: G A
authors.initials: GA
authors.lastname: Ramos
authors.affiliation: Department of Reproductive Medicine, University of California San Diego, San Diego, CA, USA.
authors.forename: D Y
authors.initials: DY
authors.lastname: LaCoursiere
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002140:California / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology / Q000209:etiology; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D009765:Obesity / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011256:Pregnancy Outcome / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013223:Statistics as Topic; D015430:Weight Gain