Am J Perinatol 2015; 32(07): 615-620
DOI: 10.1055/s-0034-1386634
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Influence of Gestational Weight Gain on the Development of Gestational Hypertension in Obese Women

John R. Barton
1   Perinatal Diagnostic Center, Baptist Health Lexington, Lexington, Kentucky
,
Saju D. Joy
2   Department of Maternal-Fetal Medicine, Carolinas Medical Center, Charlotte, North Carolina
,
Debbie J. Rhea
3   Department of Clinical Research, Alere Women's and Children's Health, Atlanta, Georgia
,
Amanda J. Sibai
4   College of Charleston, Charleston, South Carolina
,
Baha M. Sibai
5   Department of Obstetrics and Gynecology, University of Texas Medical School at Houston, Houston, Texas
› Author Affiliations
Further Information

Publication History

24 March 2014

18 June 2014

Publication Date:
08 December 2014 (online)

Abstract

Objective The objective of this study was to examine the influence of gestational weight gain on the development of gestational hypertension/preeclampsia (GHTN/PE) in women with an obese prepregnancy body mass index (BMI).

Methods Obese women with a singleton pregnancy enrolled at < 20 weeks were studied. Data were classified according to reported gestational weight gain (losing weight, under-gaining, within target, and over-gaining) from the recommended range of 11 to 9.7 kg and by obesity class (class 1 = BMI 30–34.9 kg/m2, class 2 = 35–39.9 kg/m2, class 3 = 40–49.9 kg/m2, and class 4 ≥ 50 kg/m2). Rates of GHTN/PE were compared by weight gain group overall and within obesity class using Pearson chi-square statistics.

Results For the 27,898 obese women studied, rates of GHTN/PE increased with increasing class of obesity (15.2% for class 1 and 32.0% for class 4). The incidence of GHTN/PE in obese women was not modified with weight loss or weight gain below recommended levels. Overall for obese women, over-gaining weight was associated with higher rates of GHTN/PE compared with those with a target rate for obesity classes 1 to 3 (each p < 0.001).

Conclusion Below recommended gestational weight gain did not reduce the risk for GHTN/PE in women with an obese prepregnancy BMI. These data support a gestational weight gain goal ≤ 9.7 kg in obese gravidas.

Note

This study was presented at the XVIII World Congress of the International Society for the Study of Hypertension in Pregnancy. July 9–12, 2012. Geneva, Switzerland.


 
  • References

  • 1 American College of Obstetricians and Gynecologists. ACOG Committee Opinion number 315, September 2005. Obesity in pregnancy. Obstet Gynecol 2005; 106 (3) 671-675
  • 2 Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA 2012; 307 (5) 491-497
  • 3 Wang Y, Beydoun MA. The obesity epidemic in the United States—gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis. Epidemiol Rev 2007; 29: 6-28
  • 4 Mighty HE, Fahey AJ. Obesity and pregnancy complications. Curr Diab Rep 2007; 7 (4) 289-294
  • 5 Doherty DA, Magann EF, Francis J, Morrison JC, Newnham JP. Pre-pregnancy body mass index and pregnancy outcomes. Int J Gynaecol Obstet 2006; 95 (3) 242-247
  • 6 Joy S, Istwan N, Rhea D, Desch C, Stanziano G. The impact of maternal obesity on the incidence of adverse pregnancy outcomes in high-risk term pregnancies. Am J Perinatol 2009; 26 (5) 345-349
  • 7 Bhattacharya S, Campbell DM, Liston WA, Bhattacharya S. Effect of Body Mass Index on pregnancy outcomes in nulliparous women delivering singleton babies. BMC Public Health 2007; 7: 168
  • 8 Baeten JM, Bukusi EA, Lambe M. Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health 2001; 91 (3) 436-440
  • 9 Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol 2004; 103 (2) 219-224
  • 10 Institute of Medicine; Committee on Nutritional Status During Pregnancy and Lactation. Nutrition during Pregnancy: Part I, Weight Gain; Part II, Nutrient Supplements. Washington, DC: National Academy Press; 1990
  • 11 Institute of Medicine, National Research Council. Weight gain during Pregnancy: Reexamining the Guidelines. In: Rasmussen KM, Yaktine AL, , eds. Weight Gain during Pregnancy, Reexamining the Guidelines. Washington, DC: The National Academy Press; 2009: 1-13
  • 12 World Health Organization. Preventing and Managing the Global Epidemic of Obesity: Report of the World Health Organization Consultation of Obesity. Geneva: WHO; 1997
  • 13 Mason EE, Doherty C, Maher JW, Scott DH, Rodriguez EM, Blommers TJ. Super obesity and gastric reduction procedures. Gastroenterol Clin North Am 1987; 16 (3) 495-502
  • 14 Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol 2000; 183 (1) S1-S22
  • 15 Artal R, Lockwood CJ, Brown HL. Weight gain recommendations in pregnancy and the obesity epidemic. Obstet Gynecol 2010; 115 (1) 152-155
  • 16 Power ML, Cogswell ME, Schulkin J. Obesity prevention and treatment practices of U.S. obstetrician-gynecologists. Obstet Gynecol 2006; 108 (4) 961-968
  • 17 Li N, Liu E, Guo J , et al. Maternal prepregnancy body mass index and gestational weight gain on pregnancy outcomes. PLoS ONE 2013; 8 (12) e82310
  • 18 Linné Y, Dye L, Barkeling B, Rössner S. Long-term weight development in women: a 15-year follow-up of the effects of pregnancy. Obes Res 2004; 12 (7) 1166-1178