Cited by 148Gestational Diabetes Research and ManagementMaternal and Neonatal HealthcareMaternal and Perinatal Health Interventions

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Association Between Gestational Weight Gain and Perinatal Outcomes

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Kominiarek, Michelle A., Saade, George, Mele, Lisa, Bailit, Jennifer, Reddy, Uma M., Wapner, Ronald J., Varner, Michael W., Thorp, John M., Caritis, Steve N., Prasad, Mona, Tita, Alan T.N., Sorokin, Yoram, Rouse, Dwight J., Blackwell, Sean C., Tolosa, Jorge E., for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network·2018·Obstetrics & Gynecology

DOI 10.1097/aog.0000000000002854PMC PMC6153045

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Abstract

OBJECTIVE: To evaluate the association between gestational weight gain and maternal and neonatal outcomes in a large, geographically diverse cohort. METHODS: Trained chart abstractors at 25 hospitals obtained maternal and neonatal data for all deliveries on randomly selected days over 3 years (2008–2011). Gestational weight gain was derived using weight at delivery minus prepregnancy or first-trimester weight and categorized as below, within, or above the Institute of Medicine (IOM) guidelines in this retrospective cohort study. Maternal (primary or repeat cesarean delivery, third- or fourth-degree lacerations, severe postpartum hemorrhage, hypertensive disease of pregnancy) and neonatal (preterm birth, shoulder dystocia, macrosomia, hypoglycemia) outcomes were compared among women in the gestational weight gain categories in unadjusted and adjusted analyses with odds ratios (ORs) and 95% CI reported. Covariates included age, race-ethnicity, tobacco use, insurance type, parity, prior cesarean delivery, pregestational diabetes, hypertension, and hospital type. RESULTS: Of the 29,861 women included, 51% and 21% had gestational weight gain above and below the guidelines, respectively. There was an association between gestational weight gain above the IOM guidelines and cesarean delivery in both nulliparous women (adjusted OR 1.44, 95% CI 1.31–1.59) and multiparous women (adjusted OR 1.26, 95% CI 1.13–1.41) and hypertensive diseases of pregnancy in nulliparous and multiparous women combined (adjusted OR 1.84, 95% CI 1.66–2.04). For the neonatal outcomes, gestational weight gain above the IOM guidelines was associated with shoulder dystocia (adjusted OR 1.74, 95% CI 1.41–2.14), macrosomia (adjusted OR 2.66, 95% CI 2.03–3.48), and neonatal hypoglycemia (adjusted OR 1.60, 95% CI 1.16–2.22). Gestational weight gain below the guidelines was associated with spontaneous (adjusted OR 1.50, 95% CI 1.31–1.73) and indicated (adjusted OR 1.34, 95% CI 1.12–1.60) preterm birth. CONCLUSION: In a large, diverse cohort with prospectively collected data, gestational weight gain below or above guidelines is associated with a variety of adverse pregnancy outcomes.

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Authors: Kominiarek, M. A., Saade, G., Mele, L., Bailit, J., Reddy, U. M., Wapner, R. J., Varner, M. W., Thorp, J. M., Caritis, S. N., Prasad, M., Tita, A. T. N., Sorokin, Y., Rouse, D. J., Blackwell, S. C., Tolosa, J. E., & for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network
Affiliations: University of North Carolina at Chapel Hill (US)
ORCID: Kominiarek, Michelle A.
Saade, George
Mele, Lisa
Bailit, Jennifer
Reddy, Uma M.
Wapner, Ronald J.
Varner, Michael W.
Thorp, John M.
Caritis, Steve N.
Prasad, Mona
Tita, Alan T.N.
Rouse, Dwight J.
Blackwell, Sean C.
Tolosa, Jorge E.
Venue: Obstetrics & Gynecology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2018-10
Volume: 132
Issue: 4
Pages: 875-881
ISSN: 0029-7844 (ISSN-L)
DOI: 10.1097/aog.0000000000002854
PMC: PMC6153045
OpenAlex: W2894848896
Semantic Scholar: 89b01ab09ab3a19ccbf205664c66bcfa4d07dfa9
Cited by: 148
References: 17
Citations by year: 2026: 4 · 2025: 15 · 2024: 17 · 2023: 31 · 2022: 34 · 2021: 20 · 2020: 18 · 2019: 9
FWCI: 13.23
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Obstetrics and Gynecology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (UL1TR002548)
National Center for Research Resources (UL1RR024989, UL1RR025764)
National Center for Advancing Translational Sciences
Eunice Kennedy Shriver National Institute of Child Health and Human Development (U01HD036801, U10HD040544, U10HD034208, U10HD040512, UG1HD034116, UG1HD053097, U10HD027915, U10HD040545, U10HD040560, U10HD027917, U10HD036801, U10HD021410, U10HD053097, U10HD034116, U10HD040500, U10HD040485, P2CHD050924, U10HD053118, U10HD027869, UG1HD034208, U24HD036801, UG1HD040500, UG1HD040512, UG1HD027869, UG1HD040544, UG1HD040485, UG1HD027915, UG1HD040560, UG1HD040545, K23HD076010)
Topics: Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords: gestational weight gain, IOM weight gain guidelines, cesarean section, hypertensive disorders of pregnancy, shoulder dystocia, macrosomia, neonatal hypoglycemia, preterm birth, third- and fourth-degree lacerations, postpartum hemorrhage, maternal obesity, maternal underweight, maternal outcomes, neonatal outcomes, nulliparous women
MeSH terms: Gestational Weight Gain, Adult, Female, Humans, Infant, Newborn, Pregnancy, Pregnancy Outcome, United States, Cohort Studies, Young Adult

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Association Between Gestational Weight Gain and Perinatal Outcomes

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