Effects of Gestational Weight Gain on Delivery Outcomes in an Obese, Low-Income Population

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.

Automated summary

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.