Pregnancy outcomes with weight gain above or below the 2009 institute of medicine guidelines

Julie Johnson; Rebecca G. Clifton; James M. Roberts; Leslie Myatt; John C. Hauth; Catherine Y. Spong; Michael W. Varner; Ronald J. Wapner; John M. Thorp; Brian M. Mercer; Alan M. Peaceman; Susan M. Ramin; Philip Samuels; Anthony Sciscione; Margaret Harper; Jorge E. Tolosa; George Saade; Yoram Sorokin

doi:10.1097/AOG.0b013e31828aea03

Pregnancy outcomes with weight gain above or below the 2009 institute of medicine guidelines

Julie Johnson, Rebecca G. Clifton, James M. Roberts, Leslie Myatt, John C. Hauth, Catherine Y. Spong, Michael W. Varner, Ronald J. Wapner, John M. Thorp, Brian M. Mercer, Alan M. Peaceman, Susan M. Ramin, Philip Samuels, Anthony Sciscione, Margaret Harper, Jorge E. Tolosa, George Saade, Yoram Sorokin

Research output: Contribution to journal › Article

129 Scopus citations

Abstract

OBJECTIVE: To evaluate pregnancy outcomes according to 2009 Institute of Medicine (IOM) gestational weight gain guidelines. METHODS: This study is a secondary analysis of a pre-eclampsia prevention trial among nulliparas carrying singletons. Odds ratios and 95% confidence intervals (adjusted for maternal age, race, smoking, and treatment group) were calculated based on total weight gain below or above the IOM guidelines stratified by prepregnancy body mass index (BMI). The referent group was weight gain within the guidelines. RESULTS: Of 8,293 pregnancies, 9.5% had weight gain below, 17.5% within, and 73% above IOM guidelines. With excess weight gain, all BMI categories had an increased risk of hypertensive disorders; normal weight and overweight women also had increased risk of cesarean delivery and neonatal birth weight at or above the 90^th centile but a decreased risk of weight below the 10^th centile. There were no consistent associations with insufficient weight gain and adverse outcomes. CONCLUSION: Excess weight gain was prevalent and associated with an increased risk of hypertensive disorders, cesarean delivery, and large-for-gestational-age neonates.

Original language	English (US)
Pages (from-to)	969-975
Number of pages	7
Journal	Obstetrics and gynecology
Volume	121
Issue number	5
DOIs	https://doi.org/10.1097/AOG.0b013e31828aea03
State	Published - May 1 2013
Externally published	Yes

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ASJC Scopus subject areas

Obstetrics and Gynecology

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Johnson, J., Clifton, R. G., Roberts, J. M., Myatt, L., Hauth, J. C., Spong, C. Y., Varner, M. W., Wapner, R. J., Thorp, J. M., Mercer, B. M., Peaceman, A. M., Ramin, S. M., Samuels, P., Sciscione, A., Harper, M., Tolosa, J. E., Saade, G., & Sorokin, Y. (2013). Pregnancy outcomes with weight gain above or below the 2009 institute of medicine guidelines. Obstetrics and gynecology, 121(5), 969-975. https://doi.org/10.1097/AOG.0b013e31828aea03

Pregnancy outcomes with weight gain above or below the 2009 institute of medicine guidelines. / Johnson, Julie; Clifton, Rebecca G.; Roberts, James M.; Myatt, Leslie; Hauth, John C.; Spong, Catherine Y.; Varner, Michael W.; Wapner, Ronald J.; Thorp, John M.; Mercer, Brian M.; Peaceman, Alan M.; Ramin, Susan M.; Samuels, Philip; Sciscione, Anthony; Harper, Margaret; Tolosa, Jorge E.; Saade, George; Sorokin, Yoram.

In: Obstetrics and gynecology, Vol. 121, No. 5, 01.05.2013, p. 969-975.

Research output: Contribution to journal › Article

Johnson, J, Clifton, RG, Roberts, JM, Myatt, L, Hauth, JC, Spong, CY, Varner, MW, Wapner, RJ, Thorp, JM, Mercer, BM, Peaceman, AM, Ramin, SM, Samuels, P, Sciscione, A, Harper, M, Tolosa, JE, Saade, G & Sorokin, Y 2013, 'Pregnancy outcomes with weight gain above or below the 2009 institute of medicine guidelines', Obstetrics and gynecology, vol. 121, no. 5, pp. 969-975. https://doi.org/10.1097/AOG.0b013e31828aea03

Johnson, Julie ; Clifton, Rebecca G. ; Roberts, James M. ; Myatt, Leslie ; Hauth, John C. ; Spong, Catherine Y. ; Varner, Michael W. ; Wapner, Ronald J. ; Thorp, John M. ; Mercer, Brian M. ; Peaceman, Alan M. ; Ramin, Susan M. ; Samuels, Philip ; Sciscione, Anthony ; Harper, Margaret ; Tolosa, Jorge E. ; Saade, George ; Sorokin, Yoram. / Pregnancy outcomes with weight gain above or below the 2009 institute of medicine guidelines. In: Obstetrics and gynecology. 2013 ; Vol. 121, No. 5. pp. 969-975.

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abstract = "OBJECTIVE: To evaluate pregnancy outcomes according to 2009 Institute of Medicine (IOM) gestational weight gain guidelines. METHODS: This study is a secondary analysis of a pre-eclampsia prevention trial among nulliparas carrying singletons. Odds ratios and 95% confidence intervals (adjusted for maternal age, race, smoking, and treatment group) were calculated based on total weight gain below or above the IOM guidelines stratified by prepregnancy body mass index (BMI). The referent group was weight gain within the guidelines. RESULTS: Of 8,293 pregnancies, 9.5% had weight gain below, 17.5% within, and 73% above IOM guidelines. With excess weight gain, all BMI categories had an increased risk of hypertensive disorders; normal weight and overweight women also had increased risk of cesarean delivery and neonatal birth weight at or above the 90th centile but a decreased risk of weight below the 10th centile. There were no consistent associations with insufficient weight gain and adverse outcomes. CONCLUSION: Excess weight gain was prevalent and associated with an increased risk of hypertensive disorders, cesarean delivery, and large-for-gestational-age neonates.",

author = "Julie Johnson and Clifton, {Rebecca G.} and Roberts, {James M.} and Leslie Myatt and Hauth, {John C.} and Spong, {Catherine Y.} and Varner, {Michael W.} and Wapner, {Ronald J.} and Thorp, {John M.} and Mercer, {Brian M.} and Peaceman, {Alan M.} and Ramin, {Susan M.} and Philip Samuels and Anthony Sciscione and Margaret Harper and Tolosa, {Jorge E.} and George Saade and Yoram Sorokin",

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AU - Wapner, Ronald J.

AU - Thorp, John M.

AU - Mercer, Brian M.

AU - Peaceman, Alan M.

AU - Ramin, Susan M.

AU - Samuels, Philip

AU - Sciscione, Anthony

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AU - Tolosa, Jorge E.

AU - Saade, George

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N2 - OBJECTIVE: To evaluate pregnancy outcomes according to 2009 Institute of Medicine (IOM) gestational weight gain guidelines. METHODS: This study is a secondary analysis of a pre-eclampsia prevention trial among nulliparas carrying singletons. Odds ratios and 95% confidence intervals (adjusted for maternal age, race, smoking, and treatment group) were calculated based on total weight gain below or above the IOM guidelines stratified by prepregnancy body mass index (BMI). The referent group was weight gain within the guidelines. RESULTS: Of 8,293 pregnancies, 9.5% had weight gain below, 17.5% within, and 73% above IOM guidelines. With excess weight gain, all BMI categories had an increased risk of hypertensive disorders; normal weight and overweight women also had increased risk of cesarean delivery and neonatal birth weight at or above the 90th centile but a decreased risk of weight below the 10th centile. There were no consistent associations with insufficient weight gain and adverse outcomes. CONCLUSION: Excess weight gain was prevalent and associated with an increased risk of hypertensive disorders, cesarean delivery, and large-for-gestational-age neonates.

AB - OBJECTIVE: To evaluate pregnancy outcomes according to 2009 Institute of Medicine (IOM) gestational weight gain guidelines. METHODS: This study is a secondary analysis of a pre-eclampsia prevention trial among nulliparas carrying singletons. Odds ratios and 95% confidence intervals (adjusted for maternal age, race, smoking, and treatment group) were calculated based on total weight gain below or above the IOM guidelines stratified by prepregnancy body mass index (BMI). The referent group was weight gain within the guidelines. RESULTS: Of 8,293 pregnancies, 9.5% had weight gain below, 17.5% within, and 73% above IOM guidelines. With excess weight gain, all BMI categories had an increased risk of hypertensive disorders; normal weight and overweight women also had increased risk of cesarean delivery and neonatal birth weight at or above the 90th centile but a decreased risk of weight below the 10th centile. There were no consistent associations with insufficient weight gain and adverse outcomes. CONCLUSION: Excess weight gain was prevalent and associated with an increased risk of hypertensive disorders, cesarean delivery, and large-for-gestational-age neonates.

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10.1097/AOG.0b013e31828aea03