title: Gestational Weight Gain: Association with Adverse Pregnancy Outcomes.
abstract: BackgroundIt is unclear how adherence to the Institute of Medicine's (IOM) guidelines for weight gain affects pregnancy outcomes.ObjectiveWe investigated how weight gain outside the IOM's recommendations affects the risks of adverse pregnancy outcomes.Study DesignWe performed a secondary analysis of a prospective cohort study including singleton, nonanomalous fetuses. The risks of small for gestational age (SGA), macrosomia, preeclampsia, cesarean delivery, gestational diabetes, or preterm birth were calculated for patients who gained weight below or above the IOM's recommendations based on body mass index category. A time-to-event analysis was performed to account for gestational age at delivery. A Cox proportional model was fit to estimate hazard ratios accounting for possible confounders.ResultsWomen who gained weight below recommendations were 2.5 times more likely to deliver SGA and twice as likely to deliver preterm. Normal-weight patients who gained below recommendations were 2.5 times more likely to deliver SGA and twice as likely to deliver preterm. Obese patients who gained inadequate weight were 2.5 times more likely to deliver SGA.ConclusionAmong normal-weight patients, adhering to IOM recommendations may prevent growth abnormalities and preterm delivery. Among obese patients, a minimum weight gain requirement may prevent SGA infants.
authors.affiliation: Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Hannaford
authors.affiliation: Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri.
authors.forename: Methodius G
authors.initials: MG
authors.lastname: Tuuli
authors.affiliation: Department of Obstetrics and Gynecology, University of Southern Florida, Tampa, Florida.
authors.forename: Linda
authors.initials: L
authors.lastname: Odibo
authors.affiliation: Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri.
authors.forename: George A
authors.initials: GA
authors.lastname: Macones
authors.affiliation: Department of Obstetrics and Gynecology, University of Southern Florida, Tampa, Florida.
authors.forename: Anthony O
authors.initials: AO
authors.lastname: Odibo
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data; D016640:Diabetes, Gestational / Q000453:epidemiology; D004700:Endocrine System Diseases / Q000151:congenital / Q000453:epidemiology; D005260:Female; D006130:Growth Disorders / Q000151:congenital / Q000453:epidemiology; D017408:Guidelines as Topic; D006801:Humans; D056865:Ideal Body Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D009765:Obesity / Q000150:complications; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D011446:Prospective Studies; D013851:Thinness / Q000150:complications; D015430:Weight Gain