Gestational weight gain and pregnancy outcomes in obese women - How much is enough?

Department of Obstetrics, Gynecology, and Women's Health, Saint Louis University, Сент-Луис, Michigan, United States
Obstetrics and Gynecology (Impact Factor: 4.37). 11/2007; 110(4):752-8. DOI: 10.1097/01.AOG.0000278819.17190.87
Source: PubMed

ABSTRACT To examine the effect of gestational weight change on pregnancy outcomes in obese women.
A population-based cohort study of 120,251 pregnant, obese women delivering full-term, liveborn, singleton infants was examined to assess the risk of four pregnancy outcomes (preeclampsia, cesarean delivery, small for gestational age births, and large for gestational age births) by obesity class and total gestational weight gain.
Gestational weight gain incidence for overweight or obese pregnant women, less than the currently recommended 15 lb, was associated with a significantly lower risk of preeclampsia, cesarean delivery, and large for gestational age birth and higher risk of small for gestational age birth. These results were similar for each National Institutes of Health obesity class (30-34.9, 35-35.9, and 40.0 kg/m(2)), but at different amounts of gestational weight gain.
Limited or no weight gain in obese pregnant women has favorable pregnancy outcomes.

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    • "Terminations ≥ 20 weeks due to anomalies or other reasons Missing end of pregnancy weight (n = 1022) Missing gestation for end of pregnancy weight (n = 1854) n = 115) Underweight prepregnancy BMI category ( Auckland (n = 264) Adelaide (n = 475) Cork (n = 1211) Recruited to study at 14–16 weeks (n = 5026) Study population at 14–16 weeks' (n = 4970) (n = 12) Miscarriage or termination 15–19[6] "
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    ABSTRACT: Objective. Excessive gestational weight gain (GWG) is associated with adverse maternal and child outcomes and contributes to obesity in women. Our aim was to identify early pregnancy factors associated with excessive GWG, in a contemporary nulliparous cohort. Methods. Participants in the SCOPE study were classified into GWG categories ("not excessive" versus "excessive") based on pregravid body mass index (BMI) using 2009 Institute of Medicine (IOM) guidelines. Maternal characteristics and pregnancy risk factors at 14-16 weeks were compared between categories and multivariable analysis controlled for confounding factors. Results. Of 1950 women, 17% gained weight within the recommended range, 74% had excessive and 9% inadequate GWG. Women with excessive GWG were more likely to be overweight (adjOR 2.9 (95% CI 2.2-3.8)) or obese (adjOR 2.5 (95% CI 1.8-3.5)) before pregnancy compared to women with a normal BMI. Other factors independently associated with excessive GWG included recruitment in Ireland, younger maternal age, increasing maternal birthweight, cessation of smoking by 14-16 weeks, increased nightly sleep duration, high seafood diet, recent immigrant, limiting behaviour, and decreasing exercise by 14-16 weeks. Fertility treatment was protective. Conclusions. Identification of potentially modifiable risk factors for excessive GWG provides opportunities for intervention studies to improve pregnancy outcome and prevent maternal obesity.
    Journal of obesity 01/2014; 2014:148391. DOI:10.1155/2014/148391
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    • "Approximately 24% of pregnant women in the US are obese (Bodnar et al., 2005; Mumford, Siega-Riz, Herring, & Evenson, 2008). Obesity (Sibai et al., 1995; Wolf et al., 2001) and excessive weight gain during pregnancy (Kiel et al., 2007; Raatikainen, Heiskanen, & Heinonen, 2006) are both independent risk factors for preeclampsia. In a prospective cohort study, Bodnar et al. found that risk for preeclampsia was tripled for obese pregnant women compared with their nonobese counterparts. "
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    ABSTRACT: Preeclampsia is a leading cause of perinatal mortality and morbidity, and it increases maternal risk for future cardiovascular disease. The purpose of the study was to explore the relationships among stretching exercise, autonomic cardiac response, and the development of preeclampsia. Secondary data analysis. Heart rate and pulse pressure were longitudinally examined in this secondary data analysis among women who engaged in stretching exercise daily from 18 weeks of gestation to the end of pregnancy compared with women who did walking exercise daily during the same time period. A total of 124 women were randomized to either stretching (n=60) or walking (n=64) in the parent study. Findings: Heart rates in the stretching group were consistently lower than those in the walking group. Based on the results of this secondary data analyses, a physiologic framework for possible beneficial effects of stretching exercise by enhancing autonomic responses on reducing risks for preeclampsia is proposed and discussed. If the protective effect is established, stretching exercise can be translated into nursing intervention for prenatal care.
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    ABSTRACT: Over the last 40 years, there have been significant increases in the rates of overweight and obesity in childbearing women. There has been a parallel increase in the rates of pregnancy complications including hypertension, diabetes, fetal macrosomia, and complications of delivery. Caregivers can focus on appropriate interventions during pregnancy and childbirth to improve outcomes and prevent harm.
    The Journal of perinatal & neonatal nursing 01/2009; 23(1):15-22. DOI:10.1097/JPN.0b013e318197bf1b · 1.01 Impact Factor