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. 2024 Apr;309(4):1295-1303.
doi: 10.1007/s00404-023-07000-0. Epub 2023 Mar 17.

Socioeconomic and clinical factors associated with excessive gestational weight gain

Insaf Kouba  1   2 , Jaclyn Del Pozzo  3 , Martin L Lesser  4 , Disha Shahani  4 , Moti Gulersen  3 , Luis A Bracero  3 , Matthew J Blitz  3   5
Affiliations

Socioeconomic and clinical factors associated with excessive gestational weight gain

Insaf Kouba et al. Arch Gynecol Obstet. 2024 Apr.

Abstract

Purpose: Excessive gestational weight gain (EGWG) is associated with adverse maternal and offspring outcomes but efforts to identify women at high risk for EGWG have been limited. The objective of this study is to identify socioeconomic and clinical factors associated with EGWG.

Methods: This retrospective cohort included pregnant patients who delivered live, term, singleton newborns between January 2018 and February 2020 at seven hospitals within a large health system in New York. Patients were stratified by pre-pregnancy body mass index and then classified based on whether they exceeded the Institute of Medicine guidelines for gestational weight gain (GWG) and whether they gained more than 50 pounds in pregnancy.

Results: A total of 44,872 subjects were included for analysis: 48% had EGWG and 17% had GWG exceeding 50 pounds. Patients with EGWG were more likely to be Black race, English speakers, overweight or obese pre-pregnancy, and have a mood disorder diagnosis. Patients who were underweight, multiparous, and those with gestational diabetes were less likely to have EGWG.

Conclusion: Sociodemographic and clinical findings associated with GWG > 50 pounds were similar but only overweight and not obese patients were at increased risk. Patients at risk for EGWG may benefit from early nutrition counseling and education on lifestyle changes.

Keywords: Body mass index; Gestational weight gain; Maternal weight gain; Obesity; Pregnancy.

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Conflict of interest statement

The authors report no conflicts of interest and have nothing to disclose. The authors report no financial support.

Figures

Fig. 1
Fig. 1
Flow chart of study patients. BMI, body mass index; GWG, gestational weight gain
Fig. 2
Fig. 2
Forest plot of factors associated with excessive gestational weight gain (EGWG). Note regarding reference categories: Parity 0 is the reference for other parity groups. White is the reference for race. Non-Hispanic/Latino is the reference for ethnicity. Public health insurance is the reference for insurance type. Normal BMI (18.5–24.9 kg/m2) is the reference for pre-pregnancy BMI groups. For binary factors (e.g. advanced maternal age), the absence of that condition is the reference group
Fig. 3
Fig. 3
Forest plot of factors associated with gestational weight gain (GWG) greater than 50 pounds. Note regarding reference categories: Parity 0 is the reference for other parity groups. White is the reference for race. Non-Hispanic/Latino is the reference for ethnicity. Public health insurance is the reference for insurance type. Normal BMI (18.5–24.9 kg/m2) is the reference for pre-pregnancy BMI groups. For binary factors (e.g. advanced maternal age), the absence of that condition is the reference group
See this image and copyright information in PMC

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