1379-P: Insufficient and Excessive Gestational Weight Gain across Midpregnancy to Delivery Are Associated with Multiple Adverse Maternal–Infant Outcomes: From the Camden Study

Abstract

Retrospective studies on the relationship of gestational weight gain (GWG) with pregnancy outcomes such as preterm delivery and preeclampsia are inconsistent. We examined the association of longitudinally assessed GWG above (excessive) and below (insufficient) the IOM guidelines with maternal-infant outcomes from the Camden study - a large prospective cohort in young pregnant women (n=2,444, African-American 38%, Hispanic 45%, Caucasian 17%, age 22 ± 5.2 yr., BMI 26 ± 6 kg/m2). All of the analyses were multivariable adjusted. Excessive GWG was 48%, 53%, 56% and 58% in all pregnancies and insufficient GWG was 25%, 27%, 23%, 21% assessed at gestational week of 24, 28, 32 and at delivery, respectively. At delivery, insufficient GWG was associated with increased risk of preterm delivery (<37 weeks’ gestation) (AOR 2.14, 95% CI 1.55-2.95) and small for gestational age (SGA, AOR 1.64, 95% CI 1.27-2.11). Excessive GWG was associated with higher risk of preeclampsia (AOR 1.56, 95% CI 1.08-2.27), large for gestational age (LGA, AOR 2.49, 95% CI 1.58-3.94) and a decreased risk of SGA (AOR 0.49, 95% CI 0.33-0.73). There was no significant difference in GDM. Similar results between insufficient or excessive GWG and risk of LGA, preeclampsia and SGA were observed in GWG assessed at week 24, 28, and 32, but no significant difference for preterm delivery. Significant linear trends among insufficient, adequate and excessive GWG at delivery with infant birth weight, birth length, chest and head circumferences were observed (p<0.001 to p<0.0001 for each). The relationship persisted and found as early as gestational week 24. Insufficient or excessive GWG across mid pregnancy to delivery are significantly associated with increased risk of several adverse maternal-infant outcomes. Maintaining adequate GWG from early pregnancy are important to improve the prognosis of maternal infant outcomes. Disclosure X. Chen: None. T.O. Scholl: None. Funding National Institutes of Health (R01MD007828)