Pregnancy Outcomes for Patients With Excessive Gestational Weight Gain Stratified by Class of Obesity [33D

Abstract

INTRODUCTION: Excessive gestational weight gain (EWG) increases risk of large for gestational age (LGA) neonates, hypertensive disorders of pregnancy and cesarean delivery. There is limited data on EWG in the obese population. We aim to compare pregnancy outcomes among obesity classes in women with EWG. METHODS: This is a secondary analysis from a prospective study of pregnant women undergoing fetal growth assessment. Obese participants were sorted into cohorts of adequate gestational weight gain (AWG) and EWG as defined by the Institute of Medicine guidelines. The groups were further stratified by class 1, class 2, and class 3 obesity (BMI 30–34.9, 35–39.9, >40 respectively). The primary outcome was LGA neonates. Secondary outcomes included: hypertensive disorders of pregnancy, gestational diabetes (GDM), preterm delivery (PTD), composite adverse neonatal outcomes (CANO, including neonatal ICU admission, neonatal death, seizures, intraventricular hemorrhage, respiratory distress syndrome, necrotizing enterocolitis, and pH <7.10) and small for gestational age (SGA) neonates. Chi-square tests were used to compare outcomes between the cohorts when stratified by class of obesity. RESULTS: 405 obese women were identified, of which 256 experienced EWG and 68 experienced AWG. Among all obese women, EWG was not associated with LGA (P=.35), GDM (P=.12), CANO (P=.75), gestational hypertension (0.87), preeclampsia (P=.68), PTD (P=.91), or SGA (0.21). When stratified by class of obesity there were no differences in the primary or secondary outcomes. CONCLUSION: EWG among obese women was not associated with increased risk of LGA, CANO, GDM, PTD, hypertensive disorders of pregnancy and SGA regardless of obesity class.