Association between gestational weight gain and perinatal outcomes

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network

Research output: Contribution to journalArticle

2 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)875-881
Number of pages7
JournalObstetrics and gynecology
Volume132
Issue number4
DOIs
StatePublished - Jan 1 2018

Fingerprint

Weight Gain
Odds Ratio
Guidelines
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Dystocia
Premature Birth
Mothers
Hypoglycemia
Infant, Newborn, Diseases
Weights and Measures
Postpartum Hemorrhage
Pregnancy
Lacerations
Tobacco Use
First Pregnancy Trimester
Pregnancy Outcome
Parity
Insurance
Cohort Studies
Retrospective Studies

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network (2018). Association between gestational weight gain and perinatal outcomes. Obstetrics and gynecology, 132(4), 875-881. https://doi.org/10.1097/AOG.0000000000002854

Association between gestational weight gain and perinatal outcomes. / Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network.

In: Obstetrics and gynecology, Vol. 132, No. 4, 01.01.2018, p. 875-881.

Research output: Contribution to journalArticle

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network 2018, 'Association between gestational weight gain and perinatal outcomes', Obstetrics and gynecology, vol. 132, no. 4, pp. 875-881. https://doi.org/10.1097/AOG.0000000000002854
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network. Association between gestational weight gain and perinatal outcomes. Obstetrics and gynecology. 2018 Jan 1;132(4):875-881. https://doi.org/10.1097/AOG.0000000000002854
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network. / Association between gestational weight gain and perinatal outcomes. In: Obstetrics and gynecology. 2018 ; Vol. 132, No. 4. pp. 875-881.
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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.",
author = "{Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network} and Kominiarek, {Michelle A.} and George Saade and Lisa Mele and Jennifer Bailit and Reddy, {Uma M.} and Wapner, {Ronald J.} and Varner, {Michael W.} and Thorp, {John M.} and Caritis, {Steve N.} and Mona Prasad and Tita, {Alan T.N.} and Yoram Sorokin and Rouse, {Dwight J.} and Blackwell, {Sean C.} and Tolosa, {Jorge E.}",
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AU - Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network

AU - Kominiarek, Michelle A.

AU - Saade, George

AU - Mele, Lisa

AU - Bailit, Jennifer

AU - Reddy, Uma M.

AU - Wapner, Ronald J.

AU - Varner, Michael W.

AU - Thorp, John M.

AU - Caritis, Steve N.

AU - Prasad, Mona

AU - Tita, Alan T.N.

AU - Sorokin, Yoram

AU - Rouse, Dwight J.

AU - Blackwell, Sean C.

AU - Tolosa, Jorge E.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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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