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.
Keywords
obesity - gestational weight gain - IOM guidelines - perinatal outcomes
