ACOG: Pregnancy outcomes by degree of weight gain among obesity subclasses
as presented at the Annual Clinical Meeting of the American College of Obstetricians and Gynecologists
At ACOG, held in April in Chicago, investigators from the MedStar Washington Hospital Center, Washington, D.C., presented a poster evaluating pregnancy outcomes by obesity classification using the 2009 Institute of Medicine weight gain guidelines.
They conducted a retrospective cohort analysis of 1886 obese women who delivered a singleton pregnancy at their institution from 2009 to 2012. Women were stratified based on pre-pregnancy body mass index (BMI) into subclasses of obesity: class I (BMI 30.0-34.9 kg/m2), class II (BMI 35.0-39.9 kg/m2), and class III (BMI 40.0 kg/m2 or greater).
Before pregnancy, 957 women were obese class I, 508 were obese class II, and 421 were obese class III. During pregnancy, 60.1% of women gained more than the recommended amount of weight; only 18.7% of women gained the recommended 11-20 pounds. Women with class I obesity increased their risk of hypertensive disorders and large for gestational age with excessive weight gain. Women with class II obesity increased their risk of cesarean delivery with excessive weight gain. Women with class III obesity increased their risk of cesarean delivery and hypertensive disorders with excessive weight gain. Less than recommended weight gain had no clear associations.
The researchers concluded that weight gain above the guideline was common and associated with adverse pregnancy outcomes among all subclasses of obesity.
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