Pregnancy complications and birth outcomes in obese and normal-weight women: Effects of gestational weight change

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Abstract
Objective: To compare the pregnancy course and outcomes in obese and normal-weight women and their associations with gestational weight change. Methods: Multivariate logistic regression described the relation of weight change to pregnancy course and outcomes in a retrospective study of 683 obese and 660 normal-weight women who delivered singleton living neonates. Results: Compared with normal-weight women, obese women gained an average of 5 kg (11 lb) less during pregnancy and were more likely to lose or gain no weight (11% versus less than 1%). Obese women were significantly more likely to have pregnancy complications, but the incidence of complications was not associated with weight change. Compared with obese women who gained 7–11.5 kg (15–25 lb), obese women who lost or gained no weight were at higher risk for delivery of infants under 3000 g or small for gestational age infants, and those who gained more than 16 kg (35 lb) were at twice the risk for delivery of infants who were 4000 g or heavier. Conclusion: Gestational weight change was not associated with pregnancy complications in obese or normal-weight women. To optimize fetal growth, weight gains of 7–11.5 kg (15–25 lb) for obese women and 11.5–16 kg (25–35 lb) for normal-weight women appear to be appropriate.

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