Am J Perinatol
DOI: 10.1055/s-0039-1696640
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Gestational Weight Gain and Pregnancy Outcomes among Nulliparous Women

Annie M. Dude
1  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
,
William Grobman
1  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
,
David Haas
2  Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana
,
Brian M. Mercer
3  Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio
,
Samuel Parry
4  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
,
Robert M. Silver
5  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
,
Ronald Wapner
6  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University, New York, New York
,
Deborah Wing
7  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California-Irvine, Irvine, California
,
George Saade
8  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch – Galveston, Galveston, Texas
,
Uma Reddy
9  Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Science, Yale University, New Haven, Connecticut
,
Jay Iams
10  Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio
,
Michelle A. Kominiarek
1  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
› Author Affiliations
Funding Support for the NuMoM2b study was provided by grant funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development: U10 HD063036, RTI International; U10 HD063072, Case Western Reserve University; U10 HD063047, Columbia University; U10 HD063037, Indiana University; U10HD063041, University of Pittsburgh; U10 HD063020, Northwestern University; U10 HD063046, University of California Irvine; U10 HD063048, University of Pennsylvania; and U10 HD063053, University of Utah. In addition, support was provided by respective Clinical and Translational Science Institutes to Indiana University (UL1TR001108) and University of California Irvine (UL1TR000153).
Further Information

Publication History

08 June 2019

22 July 2019

Publication Date:
06 September 2019 (online)

Abstract

Objective To determine the association between total gestational weight gain and perinatal outcomes.

Study Design Data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (NuMoM2b) study were used. Total gestational weight gain was categorized as inadequate, adequate, or excessive based on the 2009 Institute of Medicine guidelines. Outcomes examined included hypertensive disorders of pregnancy, mode of delivery, shoulder dystocia, large for gestational age or small for-gestational age birth weight, and neonatal intensive care unit admission.

Results Among 8,628 women, 1,666 (19.3%) had inadequate, 2,945 (34.1%) had adequate, and 4,017 (46.6%) had excessive gestational weight gain. Excessive gestational weight gain was associated with higher odds of hypertensive disorders (adjusted odds ratio [aOR] = 2.05, 95% confidence interval [CI]: 1.78–2.36) Cesarean delivery (aOR = 1.24, 95% CI: 1.09–1.41), and large for gestational age birth weight (aOR = 1.49, 95% CI: 1.23–1.80), but lower odds of small for gestational age birth weight (aOR = 0.59, 95% CI: 0.50–0.71). Conversely, inadequate gestational weight gain was associated with lower odds of hypertensive disorders (aOR = 0.75, 95% CI: 0.62–0.92), Cesarean delivery (aOR = 0.77, 95% CI: 0.65–0.92), and a large for gestational age birth weight (aOR = 0.72, 95% CI: 0.55–0.94), but higher odds of having a small for gestational age birth weight (aOR = 1.64, 95% CI: 1.37–1.96).

Conclusion Both excessive and inadequate gestational weight gain are associated with adverse maternal and neonatal outcomes.

Note

A version of this paper was presented at the 66th Annual Meeting of the Society for Reproductive Investigation, Paris, France, March 12 to 16, 2019.