title: Impact of Gestational Weight Gain on Perinatal Outcomes in Obese Women.
abstract: Objective This study aims to evaluate perinatal outcomes, according to gestational weight gain (GWG) in obese women. Study Design A retrospective cohort of perinatal outcomes in obese women who gained below, within, or above the 2009 Institute of Medicine guidelines and delivered ≥ 36 weeks. Additionally, outcomes, according to the rate of GWG (kg/week; minimal [< 0.16], moderate [0.16-0.49], or excessive [> 0.49]) were compared among women delivering preterm. Results Overall, 5,651 obese women delivered ≥ 36 weeks. GWG above guidelines was associated with increased cesarean section (adjusted odds ratio [aOR]: 1.44, 95% confidence interval [CI]: 1.21-1.72), gestational hypertension (aOR: 1.58, 95% CI: 1.21-2.06), and macrosomia (birth weight ≥ 4,000 g) (aOR: 2.08, 95% CI: 1.62-2.67). GWG below recommendations was associated with less large for gestational age infants (aOR: 0.60, 95% CI: 0.47-0.75). A total of 6,663 women delivered ≥ 20 weeks. Minimal weekly GWG was associated with increased spontaneous preterm birth (aOR: 1.56, 95% CI: 1.23-1.98) and more small for gestational age (SGA) infants (aOR: 1.55, 95% CI: 1.19-2.01). Excessive weekly GWG was associated with increased indicated preterm birth (aOR: 1.61, 95% CI: 1.29-2.01), cesarean section (aOR: 1.39, 95% CI: 1.20-1.61), preeclampsia (aOR: 1.83, 95% CI: 1.49-2.26), neonatal intensive care unit admission (aOR: 1.33, 95% CI: 1.08-1.63), and macrosomia (aOR: 2.40, 95% CI: 1.94-2.96). Conclusions Obese women with excessive GWG had worse outcomes than women with GWG within recommendations. Limited GWG was associated with increased spontaneous preterm birth and SGA infants.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Alabama, Birmingham, Alabama.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Durst
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Alabama, Birmingham, Alabama.
authors.forename: Amelia L M
authors.initials: AL
authors.lastname: Sutton
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Alabama, Birmingham, Alabama.
authors.forename: Suzanne P
authors.initials: SP
authors.lastname: Cliver
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Alabama, Birmingham, Alabama.
authors.forename: Alan T
authors.initials: AT
authors.lastname: Tita
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Alabama, Birmingham, Alabama.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Biggio
mesh_terms: D000328:Adult; D000407:Alabama; D001724:Birth Weight; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology*; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology; D007231:Infant, Newborn; D016015:Logistic Models; D009765:Obesity / Q000150:complications*; D036801:Parturition; D017410:Practice Guidelines as Topic; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D015430:Weight Gain; D055815:Young Adult