Gestational Weight Gain and Large for Gestational Age Neonates in a Predominantly Hispanic Population Community Hospital

To analyse changes in Gestational Weight Gain (GWG) in different Body Mass Index (BMI) categories at start of pregnancy and neonatal birth weight outcomes in a predominantly Hispanic population living in a low-income environment.

We conducted a cross sectional study of women with singleton gestation who delivered at Wyckoff Heights Medical Centre from January 1st to December 31st, 2017. BMI was categorized at first prenatal visit as normal weight (BMI= 18.5-24.9), overweight (BMI= 25-29.9) and obese (BMI >30). BMI was collected at 16-20, 24-28, and 36-38 weeks of gestation. Stratified by BMI, appropriate GWG were 25–35 pounds for normal weight (27.9%), 15–25 pounds for overweight (34.5%), and 11–20 pounds for obese (24.5%). Neonatal birth weight was categorized by Duryea percentiles and gestational age in weeks. From 831 women, normal weight (n=269), overweight (n=263), and obese (n=299) women were found. GWG was categorized as: inadequate, appropriate, or excessive based on the Institute of Medicine guidelines. The prevalence of excessive GWG was 23.1% for normal weight, 35.8% for overweight, and 37.5% for obese women. The prevalence of inadequate GWG was 48.9% for normal weight, 31.0% for overweight, and 40.6% for obese women. A significant association was found between obese women and >90 percentile neonatal birth weight (OR:2.3, 95% CI: 1.15-4.97). Obese women were more likely to have excessive GWG which is associated with maternal and neonatal adverse outcomes such as NICU admissions, gestational diabetes, hypertensive disorders in pregnancy, delivery by caesarean section, large for gestational age, and shoulder dystocia.

Keywords: Gestational weight gain; Maternal obesity; Pregnancy weight gain; Pregnancy complications