Gestational Weight Gain and Its Association With Preeclampsia and Blood Pressure Trends: A Retrospective Cohort Study

Preeclampsia has a significant negative impact on maternal and foetal health. Excessive gestational weight gain (eGWG) is defined as weight gain in excess of recommendations as per the Institute of Medicine guidelines. eGWG is a risk factor for preeclampsia.

We aimed to investigate the patterns of gestational weight gain, its relationship to the incidence of preeclampsia, trends in blood pressure and pregnancy outcomes within a hospital network in Sydney, Australia.

We conducted a retrospective cohort study within a metropolitan area health network in Sydney, Australia. Participants included all pregnant women who delivered at the facility between 1 January 2018 and 31 August 2024.

44 852 met the inclusion criteria. 958 (2.14%) women developed preeclampsia. More women had eGWG (57%) than those with recommended GWG (rGWG) or inadequate GWG (iGWG). eGWG was associated with increased incidence of caesarean section (35.08%) and postpartum haemorrhage (11.48%). eGWG correlated with increased incidence of preeclampsia (2.61% n = 668, p < 0.001). There appears to be a directly proportional relationship between weight and blood pressure-as body mass index increased, blood pressure also increased. Women with preeclampsia had higher blood pressures throughout the pregnancy compared to non-preeclampsia women. eGWG was associated with higher blood pressure throughout the pregnancy.

Excessive gestational weight gain appears to increase the risk of developing preeclampsia. Pre-pregnancy overweight and obesity increase the risk of excessive gestational weight gain as well as blood pressure and the incidence of preeclampsia. In pregnancy, weight appears to have a positive linear relationship with blood pressure.