Effects of Weight Gain on Delivery Outcomes in an Obese Pregnant Population
ACOG ePoster. Ratan B. Apr 27, 2018; 211946
Bani Ratan
Bani Ratan
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Abstract
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Introduction: The 2009 Institute of Medicine guidelines recommend 11-20 pounds weight gain for all pregnant women with a BMI ≥ 30. This study examines the effect of weight gain/loss on delivery outcomes in relation to class of obesity.

Methods: A retrospective cohort of 1,440 women receiving care at a large Medicaid clinic from 2013-2016 with pre-gravid BMI ≥ 30 was reviewed. Eligible women were non-smokers with a singleton pregnancy initiating care prior to 20 weeks. Multinomial logistic regression analysis compared gestational weight change to primary outcome of birth-weight percentile and secondary outcome of delivery type.

Results: Inclusion criteria were met by 889 women, with 485 in Class 1 (BMI 30-34.9), 218 in Class 2 (BMI 35-39.9), and 186 in Class 3 (BMI ≥ 40). Class 1 patients that lost weight were more likely to have a small-for-gestational-age (SGA) infant (P=.040) compared to Class 1 patients who had recommended weight gain. Class 2 and 3 patients had no statistically significant increase in SGA infants with weight loss or weight gain below recommendations. Class 2 patients that gained above recommendations were more likely to have a C-section during labor (P
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