THE EFFECTS OF CIGARETTE-SMOKING AND GESTATIONAL WEIGHT CHANGE ON BIRTH OUTCOMES IN OBESE AND NORMAL-WEIGHT WOMEN

Objectives. The associations of infant birth outcomes with maternal pr egravid obesity, gestational weight gain, and prenatal cigarette smoki ng were examined. Methods. A retrospective analysis of 1343 obese and normal-weight gravidas evaluated the associations of cigarette Smoking , gestational weight change, and pregravid body mass index with birthw eight, low birthweight, and small- and large-forgestational-age births . Results. Smoking was associated with the delivery of lower-birthweig ht infants for both obese and normal-weight women, and gestational wei ght gain did not eliminate the birthweight-lowering effects-of smoking . Women at highest risk of delivering lower-birthweight infants were o bese smokers whose gestational gains were less than 7 kg and normal-we ight smokers whose gestational gains were less than 11.5 kg. Conclusio ns. To balance the risks of small and large-size infants, gains of 7 t o 11.5 kg for obese women and 11.5 to 16 kg for normal weight women ap pear appropriate.