Incidence of excessive gestational weight gain among overweight and obese women.

Abstract

To determine the incidence of excessive gestational weight gain (GWG) among overweight and obese pregnant women, its associated factors, and pregnancy outcomes. A total of 355 overweight or obese singleton pregnant women who received antenatal care and delivered at Siriraj Hospital were included. Data, including obstetric characteristics, weight gain, and pregnancy outcomes, were extracted from medical records. GWG was categorized according to the Institute of Medicine recommendation. Comparisons were made between individuals with inadequate, normal, and excessive GWG. Logistic regression analysis was performed to determine independent associated factors for excessive GWG. Majority of the women were overweight (68.7%), 38.9% were nulliparous, and mean pre-pregnancy body mass index was 28.9 kg/m2. Excessive GWG was observed in 53% of the women. Women with excessive GWG had significantly higher weight gain in every trimester. Risk of excessive GWG increased in women ≤30 years of age, while gestational diabetes (GDM) significantly decreased the risk. Women with excessive GWG had a significantly higher primary cesarean section rate. Both women with normal and excessive GWG showed higher rate of having large for gestational age (LGA) infants (P=0.003). Maternal age of ≤30 years significantly increased the risk of excessive GWG (adjusted odds ratio [OR], 1.91; 95% confidence interval [95% CI], 1.11-3.27) and GDM significantly decreased this risk (adjusted OR, 0.40; 95% CI, 0.24-0.67). The incidence of excessive GWG among overweight and obese women was 53%. Maternal age of ≤30 years significantly increased this risk while women with GDM were at significantly decreased risk. Rates of primary cesarean section and fetal LGA significantly increased in women with excessive GWG.