140: Effects of low pre-pregnancy body mass index and gestational weight gain on neonatal outcomes

Abstract

140 Effects of low pre-pregnancy body mass index and gestational weight gain on neonatal outcomes Milana Berguig, Julia Timofeev, Helain Landy MedStar Georgetown University Hospital, Obstetrics and Gynecology, Washington, DC, MedStar Washington Hospital Center, Obstetrics and Gynecology, Washington, DC OBJECTIVE: To evaluate the effect of low pre-pregnancy body mass index (BMI) and low gestational weight gain on neonatal outcomes as compared to parturients with normal BMI and normal or excessive weight gain. STUDY DESIGN: A retrospective review of a multicenter cohort of deidentified data in the Consortium on Safe Labor (NICHD). This database includes information on 233,844 births from 228,668 deliveries from 2002-2008. Maternal factors and neonatal outcomes were analyzed by BMI (low BMI 18.5 kg/m, normal 18.5-24.9 kg/m) and weight gain during gestation as recommended by the Institute of Medicine 2009 guidelines (normal weight gain of 28-40lbs for women with low BMI, and 25-35lbs for women with normal BMI). Chi square and Fisher’s exact tests were used for statistical analysis, with significance determined at two-tailed 0.05. RESULTS: Low pre-pregnancy BMI showed statistically significant increases in the risk of small for gestational age (SGA) infants (OR 1.96, CI 1.93 2.00), NICU admission (OR 1.24, CI 1.21 1.26), and neonatal death (OR 1.62, CI 1.47 1.79). No statistically significant differences were seen in gestational age at delivery or need for newborn resuscitation. When considering recommended weight gain, women who gained less weight ( 28 lbs for low BMI, and 25 lbs for normal BMI) had higher risks of poor pregnancy outcomes (SGA, 5-minute Apgar score 7, NICU admission, antepartum and intrapartum stillbirth (Table). CONCLUSION: Pregnancy outcomes are influenced by both pre-pregnancy BMI and weight gain during pregnancy. These findings suggest that women can minimize their risk of neonatal morbidity and mortality by optimizing their weight prior to conception and gaining the recommended weight amount throughout the pregnancy.