Current events in Obstetrics & Gynecology, updates on new web site features and links to other web sites of interest to ObGyns.

Thursday, May 2, 2013

Trailers (48): Pregnancy outcomes and maternal weight gain

Johnson, et al. Pregnancy outcomes with weight gain above or below the 2009 Institute of Medicine guidelines.

Why should you read about this topic?

Because you want to know if your patients really benefit from sticking to the guidelines for weight gain during pregnancy

What were the authors trying to do?

Evaluate maternal and perinatal outcomes according to maternal weight gain within, above, or below the IOM 2009 guidelines

Who participated and in what setting?

Nulliparous women(N=8293) enrolled early in pregnancy between 2003-8 in an MFMU Network trial of vitamin C and vitamin E to prevent complications of hypertensive disease of pregnancy

What was the study design?

Secondary analysis

What were the main outcome measures?

Gestational hypertension or preeclampsia, cesarean delivery, preterm birth, LGA, and SGA

What were the results?

Women who gained more weight than recommended in the IOM guidelines had a higher risk of hypertensive disorders.  Normal and overweight women who gained more than the guidelines recommended had an increased risk of cesarean delivery and LGA baby, but a lower risk of SGA baby.

What is the most interesting image in the paper?

Table 4

What were the study strengths and weaknesses?

Strengths: careful prospective data collection; multiple study sites; weight gain adjusted for gestational age; multivariable analysis.   Weaknesses: self-reported pre-pregnancy weight 

What does the study contribute for your practice?

Sticking to the IOM guidelines for weight gain during pregnancy really does pay off, but apparently it is an uphill battle if 73% wind up exceeding the recommended weight gain