Skip to main content

Advertisement

SpringerLink
Log in

Does Gestational Weight Gain Affect the Risk of Adverse Maternal and Infant Outcomes in Overweight Women?

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Objective To examine the association between gestational weight gain and adverse maternal and infant outcomes among overweight women [body mass index (BMI) 26.0–29.0 kg/m2]. Methods A population-based cohort study using birth certificate data (1990–2004) from 34,143 singleton, full-term deliveries to nulliparous, Missouri residents ages 18–35. Gestational weight gain was divided into three categories: below Institute of Medicine (IOM) recommendations (<15 lbs), within IOM recommendations (15–25 lbs), and above IOM recommendations (>25 lbs). Categories of 10-lb increments were also evaluated. The primary outcomes were preeclampsia, cesarean section, macrosomia, low birth weight (LBW), and perinatal death. Adjusted relative risks and 95% confidence intervals (CI) were calculated using Mantel–Haenszel pooled estimator. Results Compared to women who gained 15–25 lbs, women who gained <15 lbs were 0.8 (95% CI 0.6–1.0), 0.9 (0.8–1.0), 0.6 (0.5–0.8), and 1.7 (1.4–2.2) times as likely to have preeclampsia, cesarean section, macrosomia, and LBW, respectively. Conversely, women who gained >25 lbs were 1.7 (1.5–1.9), 1.3 (1.2–1.4), 2.1 (1.9–2.3), and 0.6 (0.5–0.7) times as likely to have preeclampsia, cesarean section, macrosomia, and LBW, respectively. The lowest risk of adverse outcomes was for women who gained in the 6–14 and 15–24 lb categories. There was no association between gestational weight gain and perinatal death. Conclusions Increasing gestational weight gain appears to decrease the risk of LBW but elevates the risks of preeclampsia, cesarean section, and macrosomia. Overweight women should gain within current IOM recommendations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Yeh, J., & Shelton, J. A. (2005). Increasing prepregnancy body mass index: Analysis of trends and contributing variables. American Journal of Obstetrics and Gynecology, 193(6), 1994–1998.

    Article  PubMed  Google Scholar 

  2. National Center for Health Statistics (2005). Prevalence of overweight and obesity among adults in the United States. Available from: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/3and4/overweight.htm. Cited 15 May 2006.

  3. Bodnar, L. M., et al. (2005). The risk of preeclampsia rises with increasing prepregnancy body mass index. Annals of Epidemiology, 15(7), 475–482.

    Article  PubMed  Google Scholar 

  4. Baeten, J. M., Bukusi, E. A., & Lambe, M. (2001). Pregnancy complications and outcomes among overweight and obese nulliparous women. American Journal of Public Health, 91(3), 436–440.

    Article  PubMed  CAS  Google Scholar 

  5. Robinson, H. E., et al. (2005). Maternal outcomes in pregnancies complicated by obesity. Obstetrics and Gynecology, 106(6), 1357–1364.

    Article  PubMed  Google Scholar 

  6. Callaway, L. K., et al. (2006). The prevalence and impact of overweight and obesity in an Australian obstetric population. Medical Journal of Australia, 184(2), 56–59.

    PubMed  Google Scholar 

  7. Vahratian, A., et al. (2005). Maternal pre-pregnancy overweight and obesity and the risk of cesarean delivery in nulliparous women. Annals of Epidemiology, 15(7), 467–474.

    Article  PubMed  Google Scholar 

  8. Nohr, E. A., et al. (2005). Prepregnancy obesity and fetal death—A study within the Danish National Birth Cohort. Obstetrics and Gynecology, 106(2), 250–259.

    Article  PubMed  Google Scholar 

  9. Kristensen, J., et al. (2005). Pre-pregnancy weight and the risk of stillbirth and neonatal death. BJOG:An International Journal of Obstetrics and Gynaecology, 112(4), 403–408.

    Article  PubMed  Google Scholar 

  10. Cnattingius, S., et al. (1998). Prepregnancy weight and the risk of adverse pregnancy outcomes. New England Journal of Medicine, 338(3), 147–152.

    Article  PubMed  CAS  Google Scholar 

  11. Institute of Medicine (1990). Nutrition during pregnancy: Part 1: Weight gain, Part 2: Nutrient supplements. Washington, DC: National Academy Press, 468 pp.

  12. Abrams, B., Altman, S. L., & Pickett, K. E. (2000). Pregnancy weight gain: still controversial. American Journal of Clinical Nutrition, 71(5 Suppl), 1233S–1241S.

    PubMed  CAS  Google Scholar 

  13. Myles, T., et al. (2005). Evaluation of abnormal weight gain by Institute of Medicine gestational weight gain guidelines among women with normal pre-pregnancy BMI. American Journal of Obstetrics and Gynecology, 193(6), S117.

    Article  Google Scholar 

  14. Schieve, L. A., Cogswell, M. E., & Scanlon, K. S. (1998). Trends in pregnancy weight gain within and outside ranges recommended by the Institute of Medicine in a WIC population. Maternal and Child Health Journal, 2(2), 111–116.

    Article  PubMed  CAS  Google Scholar 

  15. Cogswell, M. E., et al. (1995). Gestational weight-gain among average-weight and overweight women—What is excessive. American Journal of Obstetrics and Gynecology, 172(2), 705–712.

    Article  PubMed  CAS  Google Scholar 

  16. Dietz, P. M., et al. (2006). Combined effects of prepregnancy body mass index and weight gain during pregnancy on the risk of preterm delivery. Epidemiology, 17(2), 170–177.

    Article  PubMed  Google Scholar 

  17. Linne, Y., et al. (2004). Long-term weight development in women: A 15-year follow-up of the effects of pregnancy. Obesity Research, 12(7), 1166–1178.

    Article  PubMed  Google Scholar 

  18. Walker, L. O., Sterling, B. S., & Timmerman, G. M. (2005). Retention of pregnancy-related weight in the early postpartum period: Implications for women’s health services. JOGNN—Journal of Obstetric Gynecologic and Neonatal Nursing, 34(4), 418–427.

    Article  Google Scholar 

  19. Edwards, L. E., et al. (1996). Pregnancy complications and birth outcomes in obese and normal-weight women: effects of gestational weight change. Obstetrics & Gynecology, 87(3), 389–394.

    Article  CAS  Google Scholar 

  20. Suitor, C. (Ed.) (1997). Maternal weight gain: A report of an expert work group. National Center for Education in Maternal Child Health, pp. 1–14.

  21. Caulfield, L. E., Witter, F. R., & Stoltzfus, R. J. (1996). Determinants of gestational weight gain outside the recommended ranges among black and white women. Obstetrics & Gynecology, 87(5 Pt 1), 760–766.

    Article  CAS  Google Scholar 

  22. Fretts, R. C. (2005). Etiology and prevention of stillbirth. American Journal of Obstetrics and Gynecology, 193(6), 1923–1935.

    Article  PubMed  Google Scholar 

  23. Pregnancy Nutrition Surveillance: Summary Report (2003). The Centers for Disease Control and Prevention Nutrition Surveillance System (PNSS), pp. 1–56.

  24. Kotelchuck, M. (1994). An evaluation of the Kessner adequacy of prenatal care index and a proposed adequacy of prenatal care utilization index. American Journal of Public Health, 84(9), 1414–1420.

    Article  PubMed  CAS  Google Scholar 

  25. Greenland, S. (1989). Modeling and variable selection in epidemiologic analysis. American Journal of Public Health, 79(3), 340–349.

    Article  PubMed  CAS  Google Scholar 

  26. Jazayeri, A. (2005). Macrosomia. Available from: http://www.emedicine.com/med/topic3279.htm. Cited 26 July 2006.

  27. Stotland, N. E., Hopkins, L. M., & Caughey, A. B. (2004). Gestational weight gain, macrosomia, and risk of cesarean birth in nondiabetic nulliparas. Obstetrics & Gynecology, 104(4), 671–677.

    Article  Google Scholar 

  28. Bale, J. (2003). Improving birth outcomes: meeting the challenges in the developing world. Washington, DC: The National Academy Press, 372 p.

    Google Scholar 

  29. Dodson, E., et al. (2005). Gestational weight gain and pregnancy outcomes in obese and morbidly obese women: How much is enough? American Journal of Obstetrics and Gynecology, 193(6), S178.

    Article  Google Scholar 

  30. Centers for Disease Control and Prevention (2006). Overweight and Obesity. http://www.cdc.gov/nccdphp/dnpa/obesity/. Cited 15 May 2006.

  31. Northam, S., & Knapp, T. R. (2006). The reliability and validity of birth certificates. Journal of Obstetric, Gynecologic and Neonatal Nursing, 35(1), 3–12.

    Article  Google Scholar 

  32. Dobie, S. A., et al. (1998). How well do birth certificates describe the pregnancies they report? The Washington State experience with low-risk pregnancies. Maternal and Child Health Journal, 2(3), 145–154.

    Article  PubMed  CAS  Google Scholar 

  33. Jeffery, R. W. (1996). Bias in reported body weight as a function of education, occupation, health and weight concern. Addictive Behaviors, 21(2), 217–222.

    Article  PubMed  CAS  Google Scholar 

  34. Johnston, E. M. (1991). Weight changes during pregnancy and the postpartum period. Progress in Food & Nutrition Science, 15(3), 117–157.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Community Health, Saint Louis University, St. Louis, MO, USA

    Aisha Langford, Corinne Joshu, Jen Jen Chang & Terry Leet

  2. Department of Obstetrics, Gynecology and Women’s Health, Saint Louis University, 6420 Clayton Road, St. Louis, MO, 63117, USA

    Thomas Myles & Terry Leet

Authors
  1. Aisha Langford
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Corinne Joshu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jen Jen Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thomas Myles
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Terry Leet
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas Myles.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Langford, A., Joshu, C., Chang, J.J. et al. Does Gestational Weight Gain Affect the Risk of Adverse Maternal and Infant Outcomes in Overweight Women?. Matern Child Health J 15, 860–865 (2011). https://doi.org/10.1007/s10995-008-0318-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-008-0318-4

Keywords

Search

Navigation