Gestational Weight Changes in Obese Women: Where Do We Stand? [7A

Abstract

INTRODUCTION: This study was undertaken to evaluate gestational weight changes among obese women in comparison to the 2009 IOM recommendations for a gestational weight gain (GWG) of 11 – 20 lbs. METHODS: Using the 2015 vital statistics (birth) data collected by the National Center for Health Statistics (NCHS) for singleton pregnancies, gestational weight changes were calculated and categorized as GWG of < 11 lbs, 11- 20 lbs (reference group), 21 – 30 lbs, 30 – 40 lbs, > 40lbs and gestational weight loss (GWL) of 0 – 10 lbs, and 11 – 20 lbs for women with class 1, 2 and 3 obesity. Multivariable logistic regression analyses were used to evaluate likelihood of gestational weight changes (GWG/GWL) across obesity classes accounting for age, race/ethnicity, education, marital status, insurance, WIC, prenatal care and smoking status. RESULTS: Of 859,996 obese women – 55.28%, 26.54% and 18.18% had class 1, 2 and 3 obesity respectively. Overall – 23.95% obese women achieved recommended GWG of 11 – 20 lbs, with 24.29% having GWG of 21 - 30 lbs and 30.27% having GWG of >30 lbs. While 16.68% obese women had GWG <11 lbs, only 4.79% experienced GWL. Obese women with excess GWG were more likely to be younger (OR = 1.61, 95% CI 1.56 – 1.68), unmarried (OR = 1.43, 95% CI 1.40 – 1.45), and smokers (OR = 1.19, 95% CI 1.16 – 1.22). CONCLUSION: Distinct gestational weight changes are seen across the maternal obesity spectrum with several key sociodemographic characteristics associated with excess and inadequate GWG.