Women who are classified as severely obese at conception have increased risks of infant and maternal mortality, hypertensive disorders of pregnancy, gestational diabetes, large for gestational age infants, and cesarean delivery than non-obese women at conception.
We conducted a cross-sectional study, women with a singleton gestation, delivered at Wyckoff Hospital Medical Center from January 1 to December 31, 2017. BMI was categorized at their first prenatal visit. Gestational weight gain (GWG) were categorized as appropriate and excessive based on IOM guidelines. All mothers underwent a 1hr 50g glucose challenge test (GCT) at 28 weeks, if the GCT was abnormal (greater than 130 mg/dL), they were referred for a 3 hr 100g glucose tolerance test (GTT).
Among 831 women, normal weight (n=269), overweight (n=263), and obese (n=299) mothers were found. Mothers were stratified by BMI, appropriate GWG were 25–35lbs for normal-weight (27.9%), 15–25 lbs for overweight (34.5%), and 11–20lbs for obese (24.5%). The prevalence of excessive GWG was 23.1%, 35.8% and 37.5% respectively for normal weight, overweight, and obese women. 61% of obese women with excessive GWG and 38% of obese women with normal weight gain were noted to have chronic hypertension (OR 1.1, 95% CI 0.3–4.2). A significant association were found between excessive GWG and an elevated 1 hr GCT in obese mothers (OR 0.4, 95% CI 0.16–1.016) and between obese mothers with excessive GWG and LGA birth weight (OR 2.3, 95% CI 1.15–4.97).
Women with an abnormal initial pregnancy BMI that have an excessive GWG are at risk for adverse maternal and neonatal outcomes.