Rate of Maternal Weight Gain Impacts Size of Neonate

Regardless of BMI, too high or low rate of weight gain tied to adverse pregnancy outcomes

WEDNESDAY, Aug. 31 (HealthDay News) -- Greater than recommended rates of weight gain during the second and third trimesters increase the odds of large-for-gestational-age babies regardless of prepregnancy maternal body mass index (BMI), and gaining at a lower than recommended rate increases the odds of small-for-gestational age babies for all except the most obese women, according to a study published in the September issue of Obstetrics & Gynecology.

Danielle E. Durie, M.D., M.P.H, from the University of Rochester Medical Center in N.Y., and colleagues, estimated the effect of second and third trimester rate of weight gain on pregnancy outcomes in a retrospective study of singleton live births in 73,977 women. Grouped initially according to prepregnancy BMI, the women's rates of weight gain were calculated and classified as having less than, within, or greater than recommended rates of weight gain. Within each BMI class, maternal and neonatal outcomes were evaluated based on rate of weight gain.

The investigators found that 4 percent of the women were underweight, 48 percent were normal weight, and 24 percent each were overweight and obese (13 percent class I, 6 percent class II, and 5 percent class III). In all BMI groups except obese classes II and III, gaining less than recommended rates was correlated with increased odds of small-for-gestational-age neonates. Gaining more than recommended rates was correlated with increased odds of large-for-gestational-age neonates in all BMI groups, and elevated odds of cesarean delivery in all groups except for women who were underweight or obese class III.

"Suboptimal and excessive rates of gestational weight gain are associated with adverse pregnancy outcomes in nonobese women," the authors write.

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