Pregnancy outcome according to gestational weight gain on the basis of 2009 Institute of medicine(IOM) recommendations

Abstract

[한글]

[영문]Objectives: The aim of this study was to quantify the relationship between weekly maternal weight gain during pregnancy and birth weight. We also evaluated the effects of gestational weight gain on both maternal and neonatal outcomes using pre-pregnancy BMI and the 2009 IOM recommendations.Methods: A retrospective cohort study was conducted. Study population consisting of 3,426 singleton pregnancies delivered at Yonsei University Health System in Seoul, Korea from January 1, 2006 through December 31, 2009. Subject women were grouped into four BMI categories: underweight (<18.5), normal weight (18.5-24.9), overweight (25-29.9), and obese (≥30). Gestational weight gain was categorized as “Less” if it was below the IOM recommended range for pre-pregnancy BMI, “Within” if it was within this range, and “More” if it was above the set range.Results: Maternal weight gain between 30 to 40 gestational weeks having the greatest effect on birth weight. "More" weight gain group had increased odds of pregnancy induced hypertension (PIH) and gestational diabetes mellitus (GDM). Especially, overweight and obese women with excessive weight gains had significantly increased odds of PIH (overweight: OR, 1.66; 95% CI: 1.15-2.43, obesity: OR, 2.14; 95% CI: 1.10-3.87) and GDM(overweight: OR, 1.94; 95% CI: 1.63-3.52, obesity: OR, 4.0; 95% CI: 2.46-9.54).Underweight women with “Less” or “Within” maternal weight gain groups had significantly increased odds of delivering an infant with SGA (Less: OR, 1.82; 95% CI: 1.28-2.58, Within: OR, 1.57; 95% CI: 1.08-2.27 ) and "More" weight gain group had significantly increased odds of delivering an infant with LGA (normal weight: OR, 1.74; 95% CI: 1.31-2.31, overweight: OR, 3.53; 95% CI: 2.31-5.38, obesity: OR, 2.75; 95% CI: 1.59-4.72). Conclusions: During the period between 30 to 40 gestational weeks, maternal gestational weight gain has the largest influence on birth weight. Overweight and obese women with excessive gestational weight gain had a significantly increased risk of adverse pregnancy outcome.Therefore, physicians should not only monitor pre-pregnancy BMI but also maternal weight gain