A New Category of Gestational Weight Gain Optimizes Outcomes in Pregnancies with Obesity

To evaluate the association of stable weight or low gestational gain (GWG) with perinatal outcomes among pre-pregnancy obesity classes. Retrospective cohort study singleton pregnancies >35 weeks at Kaiser Permanente Northern California 2009-2012. We abstracted measured ≤10 and delivery weights, birth from electronic health records. Logistic regression models estimated adjusted odds ratios (aORs) four GWG categories: loss ( >-2 kg), weight/low (-2 to < 5 within guidelines (5 9 kg; referent), above >9 kg) for outcomes: hypertensive disorders (HDP), cesarean (CD), small- large-for-gestational-age neonate (SGA LGA), neonatal length-of-stay (LOS) neonatal-intensive-care-unit (NICU) admission. Models clinical behavioral covariates were stratified by classes I, II, III. Among 17,563 pregnant women II III, 14%, 21%, 27% respectively had gain. Compared guidelines, was associated overall improved all (Table 1). An exception increased SGA class III [aOR=2.92 (95%CI:1.37-6.24)], offset lower a prolonged length-of-stay, no increase in rate NICU Weight similarly outcomes, but 2.60- 2.74-fold higher I respectively. In this community-based, diverse sample weight, maintaining 2 (2 when compared IOM maternal This may be considered new promising category warranting further evaluation effort optimize complicated obesity.