To evaluate the 2009 Institute of Medicine weight gain in pregnancy guidelines for overweight (BMI 25-29.9) and obese (BMI ≥ 30) women.
Retrospective cohort study from a single institution involving a primarily indigent population. From January 1, 2002 to April 30, 2011, women presenting with a BMI recorded in the 1st trimester and a subsequent delivery weight were included. The study cohort included singleton infants, excluding preexisting maternal hypertension. Overweight and obese women were compared to women with a normal BMI (18.5-24.9) using three categories of weight gain (weight gain under, within, and above the recommended guidelines). Standard methods were used for statistical analysis.
During the study period, 16,428 overweight women were identified: 2,625 gained below, 6,156 gained within, and 7,647 gained above the guidelines. In addition, 11,607 obese women were included: 2,120 gained below, 3,840 gained within, and 5,647 gained above the guidelines. Overweight and obese women gaining less than the recommended weight gain had significant adverse outcomes including PTB 4000g, and >90%), and cesarean delivery for labor dystocia. Overweight and obese women gaining above the recommended weight gain guidelines were found to have fewer preterm births (4,000g and >90%), labor induction, cesarean delivery, chorioamnionitis, ICN admissions, preeclampsia, and 3rd and 4th degree lacerations.
The multiple disadvantages of weight gain above or below the guidelines in overweight and obese women far exceed the benefits of weight gain outside these Institute of Medicine recommendations.
© 2012 Mosby, Inc. Published by Elsevier Inc. All rights reserved.