期刊
SOUTHERN MEDICAL JOURNAL
卷 114, 期 11, 页码 686-691出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.14423/SMJ.0000000000001320
关键词
gestational diabetes mellitus; gestational weight gain; obesity; preterm birth; small-for-gestational-age
Results of the study suggest that obese women in obesity class 1 who lose weight may have a higher chance of giving birth to small-for-gestational-age infants, while those in obesity classes 2 and 3 may not have a significant increase in such risk with weight loss or inadequate weight gain. Additionally, weight loss in class 1 and 2 obese women was associated with a higher likelihood of preterm delivery and preterm labor, whereas class 3 obese patients did not show this association. Obese class 3 women who lost weight were more likely to develop gestational diabetes mellitus.
Objective To examine the effects of weight gain/loss on delivery outcomes stratified by class of obesity in an obese, low-income, predominantly minority population. Methods A retrospective review of a cohort of 1428 women receiving care at a large Medicaid clinic from 2013 to 2016 with pregravid body mass index >= 30 was conducted. Multinomial logistic regression analysis was used to compare differences in gestational weight change to the primary outcomes of birth-weight percentile and delivery type and secondary outcomes of preterm delivery, preterm labor, gestational diabetes mellitus, and gestational hypertension. Results Obesity class 1 patients who lost weight were more likely to have a small-for-gestational-age (SGA) infant compared with those who had recommended weight gain. Obesity classes 2 and 3 patients had no statistically significant increase in SGA infants with weight loss or weight gain below current recommendations. Obesity classes 1 and 2 patients with weight loss had a statistically significant increase in both preterm delivery and preterm labor; however, class 3 patients did not. Obesity class 3 patients who lost weight were significantly more likely to have gestational diabetes mellitus. Conclusions Obesity class 3 women may benefit from less weight gain than current recommendations without increasing their risk of SGA infants or preterm birth, especially if gestational diabetes mellitus is present.
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