Gestational weight gain and unplanned or emergency cesarean delivery in the United States

In the United States, the rates of cesarean delivery are well above the World Health Organization recommended target. Although obesity is a widely established risk factor for cesarean delivery, there is limited population-based research that examines the relationship between gestational weight gain and cesarean delivery.

To determine the association between gestational weight gain and unplanned or emergency cesarean delivery.

We examined 2107 mothers from the Infant Feeding Practices Study II 2005-2007. The Institute of Medicine's current guidelines were used to define categories of gestational weight gain: inadequate (less than the recommended guideline), adequate (within the recommended guideline) and excessive (above the recommended guideline).

Approximately 49.3% and 13.6% of the participants had excessive weight gain and unplanned or emergency cesarean delivery, respectively. A Greater proportion of women with excessive weight gain had an unplanned or emergency cesarean delivery followed by women with adequate and inadequate weight gain, respectively (17.8%, 10.0%, 8.8%; p<0.001). In the multivariable model, compared to women with adequate weight gain, the odds of unplanned or emergency cesarean delivery were higher among women with excessive weight gain (OR 1.56, 95% CI 1.07-2.27, p=0.020).

Women with excessive gestational weight gain are more likely to experience an unplanned or emergency cesarean delivery, which increases the risk for poor maternal-infant health outcomes.

It is critical to identify populations at increased risk of unplanned or emergency cesarean delivery and provide preconception and prenatal counseling to achieve and maintain the recommended weight gain for optimal maternal-infant health outcomes.