Associations of gestational weight loss with birth-related outcome: a retrospective cohort study
Article first published online: 4 NOV 2010
© 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 118, Issue 1, pages 55–61, January 2011
How to Cite
Beyerlein, A., Schiessl, B., Lack, N. and Von Kries, R. (2011), Associations of gestational weight loss with birth-related outcome: a retrospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 118: 55–61. doi: 10.1111/j.1471-0528.2010.02761.x
- Issue published online: 10 DEC 2010
- Article first published online: 4 NOV 2010
- Accepted 4 August 2010. Published Online 4 November 2010.
- maternal body mass index;
- weight loss
Please cite this paper as: Beyerlein A, Schiessl B, Lack N, von Kries R. Associations of gestational weight loss with birth-related outcome: a retrospective cohort study. BJOG 2011;118:55–61.
Objective Although the prevention of gestational weight loss (GWL) has become a priority for clinicians in the past few decades, recent work has suggested that GWL may be beneficial for obese mothers. We aimed to identify the potential beneficial or adverse associations of GWL with pregnancy outcome stratified by maternal body mass index (BMI) category.
Design Retrospective cohort study.
Setting and population Data on 709 575 singleton deliveries in Bavarian obstetric units from 2000–2007 were extracted from a standard dataset for which data are regularly collected for the national benchmarking of obstetric units.
Methods We calculated the odds ratios (ORs) for adverse pregnancy outcome by GWL (explanatory variable) compared with nonexcessive weight gain with adjustment for confounders and stratification by BMI category (underweight, BMI < 18.5 kg/m2; normal weight, BMI = 18.5–24.9 kg/m2; overweight, BMI = 25–29.9 kg/m2; obese class I, BMI = 30–34.9 kg/m2; obese class II, BMI = 35–39.9 kg/m2; obese class III, BMI ≥ 40 kg/m2).
Main outcome measures Pre-eclampsia, nonelective caesarean section, preterm delivery, small or large for gestational age (SGA/LGA) birth and perinatal mortality.
Results GWL was associated with a decreased risk of pregnancy complications, such as pre-eclampsia and nonelective caesarean section, in overweight and obese women [e.g. OR = 0.65 (95% confidence interval: 0.51, 0.83) for nonelective caesarean section in obese class I women]. The risks of preterm delivery and SGA births, by contrast, were significantly higher in overweight and obese class I/II mothers [e.g. OR = 1.68 (95% confidence interval: 1.37, 2.06) for SGA in obese class I women]. In obese class III women, no significantly increased risks of poor outcomes for infants were observed.
Conclusions The association of GWL with a decreased risk of pregnancy complications appears to be outweighed by increased risks of prematurity and SGA in all but obese class III mothers.