PREGNANCY COMPLICATIONS AND BIRTH OUTCOMES IN OBESE AND NORMAL-WEIGHTWOMEN - EFFECTS OF GESTATIONAL WEIGHT CHANGE

Objective: To compare the pregnancy course and outcomes in obese and n ormal-weight women and their associations with gestational weight chan ge. Methods: Multivariate logistic regression described the relation o f weight change to pregnancy course and outcomes in a retrospective st udy of 683 obese and 660 normal-weight women who delivered singleton l iving neonates. Results: Compared with normal-weight women, obese wome n gained an average of 5 kg (11 lb) less during pregnancy and were mor e likely to lose or gain no weight (11% versus less than 1%). Obese wo men were significantly more likely to have pregnancy complications, bu t the incidence of complications was not associated with weight change . Compared with obese women who gained 7-11.5 kg (15-25 lb), obese wom en who lost or gained no weight were at higher risk for delivery of in fants 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 ch ange was not associated with pregnancy complications in obese or norma l-weight women. To optimize fetal growth, weight gains of 7-11.5 kg (1 5-25 lb) for obese women and 11.5-16 kg (25-35 lb) for normal-weight w omen appear to be appropriate.