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Published on: September 12, 2017
Association Between Gestational Weight Gain and Perinatal Outcomes
Michelle A Kominiarek1, George Saade, Lisa Mele
1Departments of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, University of Texas Medical Branch, Galveston, Texas, MetroHealth Medical Center-Case Western Reserve University, Cleveland, Ohio, Columbia University, New York, New York, University of Utah Health Sciences Center, Salt Lake City, Utah, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, University of Pittsburgh, Pittsburgh, Pennsylvania, The Ohio State University, Columbus, Ohio, University of Alabama at Birmingham, Birmingham, Alabama, Wayne State University, Detroit, Michigan, Brown University, Providence, Rhode Island, University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, Texas, and Oregon Health & Science University, Portland, Oregon; the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Gestational weight gain outside Institute of Medicine (IOM) guidelines is linked to adverse maternal and neonatal outcomes. Both excessive and insufficient weight gain during pregnancy increase risks for complications.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Public Health
Background:
- Gestational weight gain (GWG) is a critical factor in pregnancy health.
- Deviations from recommended GWG guidelines are associated with various maternal and neonatal complications.
- Understanding these associations is crucial for optimizing pregnancy outcomes.
Purpose of the Study:
- To evaluate the association between gestational weight gain (GWG) and maternal and neonatal outcomes.
- To analyze GWG in relation to Institute of Medicine (IOM) guidelines in a large, diverse cohort.
- To identify specific adverse outcomes linked to GWG below or above recommended levels.
Main Methods:
- Retrospective cohort study involving 29,861 deliveries across 25 hospitals from 2008-2011.
- GWG categorized as below, within, or above IOM guidelines based on delivery weight and prepregnancy/first-trimester weight.
- Maternal (cesarean delivery, hypertensive disease) and neonatal (preterm birth, shoulder dystocia, macrosomia, hypoglycemia) outcomes were compared using adjusted odds ratios (ORs) and 95% confidence intervals (CIs).
Main Results:
- Gestational weight gain above IOM guidelines was associated with increased odds of cesarean delivery (nulliparous OR 1.44; multiparous OR 1.26) and hypertensive diseases of pregnancy (OR 1.84).
- Excessive GWG also correlated with higher risks of shoulder dystocia (OR 1.74), macrosomia (OR 2.66), and neonatal hypoglycemia (OR 1.60).
- Gestational weight gain below IOM guidelines was linked to increased odds of spontaneous (OR 1.50) and indicated (OR 1.34) preterm birth.
Conclusions:
- Gestational weight gain outside of recommended Institute of Medicine (IOM) guidelines is significantly associated with adverse maternal and neonatal outcomes.
- Both excessive and insufficient GWG pose distinct risks, highlighting the importance of adherence to guidelines for healthier pregnancies.
- Findings from this large, diverse cohort underscore the need for monitoring and managing GWG to mitigate pregnancy complications.
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