Low gestational weight gain (+2.0 to 4.9 kg) for singleton-term gestations associated with favorable perinatal outcomes for all prepregnancy obesity classesAJOG Global Reports at a Glance
BACKGROUND: Previous studies that evaluated low gestational weight gain or weight loss among prepregnancy obesity classes have not determined the amount of gestational weight gain associated with the lowest risk of adverse perinatal outcomes and neonatal morbidity among singleton term births. OBJECT...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | AJOG Global Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666577823000874 |
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| author | Emilia G. Wilkins, MD, MPH Baiyang Sun, MPH Alexis S. Thomas, MPH Amy Alabaster, MPH Mara Greenberg, MD Jeffrey D. Sperling, MD, MS David L. Walton, MD Jasmin Alves, PhD Erica P. Gunderson, PhD, MPH, MS, RD |
| author_facet | Emilia G. Wilkins, MD, MPH Baiyang Sun, MPH Alexis S. Thomas, MPH Amy Alabaster, MPH Mara Greenberg, MD Jeffrey D. Sperling, MD, MS David L. Walton, MD Jasmin Alves, PhD Erica P. Gunderson, PhD, MPH, MS, RD |
| author_sort | Emilia G. Wilkins, MD, MPH |
| collection | DOAJ |
| description | BACKGROUND: Previous studies that evaluated low gestational weight gain or weight loss among prepregnancy obesity classes have not determined the amount of gestational weight gain associated with the lowest risk of adverse perinatal outcomes and neonatal morbidity among singleton term births. OBJECTIVE: This study aimed to evaluate the relationship of specific gestational weight gain categories of weight loss, stable weight, and low gain considered below the 2009 Institute of Medicine guidelines to perinatal outcomes and neonatal morbidity for singleton, term live births among prepregnancy obesity classes. STUDY DESIGN: This was a retrospective cohort study of 18,476 women among 3 classes of prepregnancy obesity, based on measured prepregnancy weight, and delivering a live singleton pregnancy at ≥37 weeks of gestation at a Kaiser Permanente Northern California hospital (2009–2012). Variables from electronic medical records included perinatal outcomes, sociodemographics, and measured prepregnancy and delivery weights to calculate total gestational weight gain, used to define 5 gestational weight gain categories: weight loss (<−2.0 kg), stable weight (−2.0 to +1.9 kg), low gain (+2.0 to 4.9 kg), gain within guidelines (+5.0 to 9.1 kg; referent), and gain above guidelines (>9.1 kg). Logistic regression models estimated adjusted odds ratios and 95% confidence intervals of maternal and newborn perinatal outcomes (hypertensive disorders, cesarean delivery, size for gestational age, length of stay, neonatal intensive care unit admission) associated with gestational weight gain categories stratified by prepregnancy obesity classes 1, 2, and 3. RESULTS: Low gain occurred in 8%, 12%, and 13% of women in obesity class 1 (body mass index, 30.0–34.9), class 2 (body mass index, 35.0–39.9), and class 3 (body mass index, ≥40), respectively. Compared with gestational weight gain within Institute of Medicine guidelines, low gain was associated with similar or improved maternal and newborn perinatal outcomes for all obesity classes without increased odds of neonatal intensive care unit admission, neonatal length of stay ≥3 days, or small for gestational age. The percentages of small for gestational age for the low gain category were 4.4%, 3.0%, and 4.3% among prepregnancy obesity classes 1, 2, and 3, respectively, and comparable with the gestational weight gain within the guideline category (P>.05). The adjusted odds ratios of small-for-gestational age were not statistically significant for all obesity classes; class 1 (1.16; 95% confidence interval, 0.79–1.71) , class 2 (1.05; 95% confidence interval 0.58–1.93), and class 3 (2.03; 95% confidence interval 0.97–4.27). CONCLUSION: Lower gestational weight gain of +2.0 to 4.9 kg showed the most favorable perinatal outcomes, without higher small for gestational age or neonatal morbidity for all obesity classes. |
| first_indexed | 2024-03-13T00:46:13Z |
| format | Article |
| id | doaj.art-2c0a97de22a442419ac3624024307c14 |
| institution | Directory Open Access Journal |
| issn | 2666-5778 |
| language | English |
| last_indexed | 2024-03-13T00:46:13Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | AJOG Global Reports |
| spelling | doaj.art-2c0a97de22a442419ac3624024307c142023-07-09T04:22:27ZengElsevierAJOG Global Reports2666-57782023-08-0133100246Low gestational weight gain (+2.0 to 4.9 kg) for singleton-term gestations associated with favorable perinatal outcomes for all prepregnancy obesity classesAJOG Global Reports at a GlanceEmilia G. Wilkins, MD, MPH0Baiyang Sun, MPH1Alexis S. Thomas, MPH2Amy Alabaster, MPH3Mara Greenberg, MD4Jeffrey D. Sperling, MD, MS5David L. Walton, MD6Jasmin Alves, PhD7Erica P. Gunderson, PhD, MPH, MS, RD8Department of Obstetrics and Gynecology, Kaiser Permanente, Richmond Medical Center, CA (Dr Wilkins)Division of Research, Kaiser Permanente Northern California, Oakland, CA (Mses Sun, Thomas, and Alabaster and Drs Alves and Gunderson)Division of Research, Kaiser Permanente Northern California, Oakland, CA (Mses Sun, Thomas, and Alabaster and Drs Alves and Gunderson)Division of Research, Kaiser Permanente Northern California, Oakland, CA (Mses Sun, Thomas, and Alabaster and Drs Alves and Gunderson)Department of Obstetrics and Gynecology, Kaiser Permanente, Oakland Medical Center, Oakland, CA (Dr Greenberg)Department of Obstetrics and Gynecology, Kaiser Permanente, Modesto Medical Center, Modesto, CA (Dr Sperling)Valley Children's Hospital, Madera, CA (Dr Walton)Division of Research, Kaiser Permanente Northern California, Oakland, CA (Mses Sun, Thomas, and Alabaster and Drs Alves and Gunderson)Division of Research, Kaiser Permanente Northern California, Oakland, CA (Mses Sun, Thomas, and Alabaster and Drs Alves and Gunderson); Department of Health System Sciences, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA (Dr Gunderson).; Corresponding author: Erica P. Gunderson, PhD, MPH, MS, RD.BACKGROUND: Previous studies that evaluated low gestational weight gain or weight loss among prepregnancy obesity classes have not determined the amount of gestational weight gain associated with the lowest risk of adverse perinatal outcomes and neonatal morbidity among singleton term births. OBJECTIVE: This study aimed to evaluate the relationship of specific gestational weight gain categories of weight loss, stable weight, and low gain considered below the 2009 Institute of Medicine guidelines to perinatal outcomes and neonatal morbidity for singleton, term live births among prepregnancy obesity classes. STUDY DESIGN: This was a retrospective cohort study of 18,476 women among 3 classes of prepregnancy obesity, based on measured prepregnancy weight, and delivering a live singleton pregnancy at ≥37 weeks of gestation at a Kaiser Permanente Northern California hospital (2009–2012). Variables from electronic medical records included perinatal outcomes, sociodemographics, and measured prepregnancy and delivery weights to calculate total gestational weight gain, used to define 5 gestational weight gain categories: weight loss (<−2.0 kg), stable weight (−2.0 to +1.9 kg), low gain (+2.0 to 4.9 kg), gain within guidelines (+5.0 to 9.1 kg; referent), and gain above guidelines (>9.1 kg). Logistic regression models estimated adjusted odds ratios and 95% confidence intervals of maternal and newborn perinatal outcomes (hypertensive disorders, cesarean delivery, size for gestational age, length of stay, neonatal intensive care unit admission) associated with gestational weight gain categories stratified by prepregnancy obesity classes 1, 2, and 3. RESULTS: Low gain occurred in 8%, 12%, and 13% of women in obesity class 1 (body mass index, 30.0–34.9), class 2 (body mass index, 35.0–39.9), and class 3 (body mass index, ≥40), respectively. Compared with gestational weight gain within Institute of Medicine guidelines, low gain was associated with similar or improved maternal and newborn perinatal outcomes for all obesity classes without increased odds of neonatal intensive care unit admission, neonatal length of stay ≥3 days, or small for gestational age. The percentages of small for gestational age for the low gain category were 4.4%, 3.0%, and 4.3% among prepregnancy obesity classes 1, 2, and 3, respectively, and comparable with the gestational weight gain within the guideline category (P>.05). The adjusted odds ratios of small-for-gestational age were not statistically significant for all obesity classes; class 1 (1.16; 95% confidence interval, 0.79–1.71) , class 2 (1.05; 95% confidence interval 0.58–1.93), and class 3 (2.03; 95% confidence interval 0.97–4.27). CONCLUSION: Lower gestational weight gain of +2.0 to 4.9 kg showed the most favorable perinatal outcomes, without higher small for gestational age or neonatal morbidity for all obesity classes.http://www.sciencedirect.com/science/article/pii/S2666577823000874body mass indexclinical practicegestational weight gainobesitypregnancy |
| spellingShingle | Emilia G. Wilkins, MD, MPH Baiyang Sun, MPH Alexis S. Thomas, MPH Amy Alabaster, MPH Mara Greenberg, MD Jeffrey D. Sperling, MD, MS David L. Walton, MD Jasmin Alves, PhD Erica P. Gunderson, PhD, MPH, MS, RD Low gestational weight gain (+2.0 to 4.9 kg) for singleton-term gestations associated with favorable perinatal outcomes for all prepregnancy obesity classesAJOG Global Reports at a Glance AJOG Global Reports body mass index clinical practice gestational weight gain obesity pregnancy |
| title | Low gestational weight gain (+2.0 to 4.9 kg) for singleton-term gestations associated with favorable perinatal outcomes for all prepregnancy obesity classesAJOG Global Reports at a Glance |
| title_full | Low gestational weight gain (+2.0 to 4.9 kg) for singleton-term gestations associated with favorable perinatal outcomes for all prepregnancy obesity classesAJOG Global Reports at a Glance |
| title_fullStr | Low gestational weight gain (+2.0 to 4.9 kg) for singleton-term gestations associated with favorable perinatal outcomes for all prepregnancy obesity classesAJOG Global Reports at a Glance |
| title_full_unstemmed | Low gestational weight gain (+2.0 to 4.9 kg) for singleton-term gestations associated with favorable perinatal outcomes for all prepregnancy obesity classesAJOG Global Reports at a Glance |
| title_short | Low gestational weight gain (+2.0 to 4.9 kg) for singleton-term gestations associated with favorable perinatal outcomes for all prepregnancy obesity classesAJOG Global Reports at a Glance |
| title_sort | low gestational weight gain 2 0 to 4 9 kg for singleton term gestations associated with favorable perinatal outcomes for all prepregnancy obesity classesajog global reports at a glance |
| topic | body mass index clinical practice gestational weight gain obesity pregnancy |
| url | http://www.sciencedirect.com/science/article/pii/S2666577823000874 |
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