Objective: To compare the pregnancy course and outcomes in obese and normal-weight women and their associations with gestational weight change. Methods: Multivariate logistic regression described the relation of weight change to pregnancy course and outcomes in a retrospective study of 683 obese and 660 normal-weight women who delivered singleton living neonates. Results: Compared with normal-weight women, obese women gained an average of 5 kg (11 lb) less during pregnancy and were more likely to lose or gain no weight (11% versus less than 1%). Obese women were significantly more likely to have pregnancy complications, but the incidence of complications was not associated with weight change. Compared with obese women who gained 7-11.5 kg (15-25 lb), obese women who lost or gained no weight were at higher risk for delivery of infants under 3000 g or small for gestational age infants, and those who gained more than 16 kg (33 lb) were at twice the risk for delivery of infants who were 4000 g or heavier. Conclusion: Gestational weight change was not associated with pregnancy complications in obese or normal-weight women. To optimize fetal growth, weight gains of 7-11.5 kg (15-25 lb) for obese women and 11.5-16 kg (25-35 lb) for normal-weight women appear to be appropriate.
Bibliographical noteFunding Information:
From the Department of Obstetrics and Gynecology, St. Paul-Ramsey Medical Center, St. Paul; the Divisions of Health Policy and Management, Maternal and Child Health, and Epidemiology, School of Public Health, St. Paul; and Health Start, Inc., St. Paul, Minnesota. Supported in part by a grant from the Maternal and Child Health Bureau, MCJ-O09118-07-O.