Obesity class I and II and IOM 2009 gestational weight gain recommendations 5–9 kg. An audit on 10,000 term singleton deliveries

Abstract

Objectives

To compare several maternal-fetal morbidities comparing the Institute of Medicine IOM 2009 recommendations (IOMR: 5–9 kg in all obese women) between women with adequate gestational weight gain (GWG) and Inadequate (less than 5 kg), and excessive those gaining more than 9 kg among obese women class I (30–34.9 kg/m²) and class II (35–39.9 kg/m²).

Study design

South-Reunion University’s maternity (Reunion Island, Indian Ocean). 21-Year-observational cohort study (2001–2021). Epidemiological perinatal database with information on obstetrical and neonatal risk factors.

Main outcome measures

Cesarean sections, preeclampsia, means birthweight, rate of small (SGA) or large (LGA) for gestational age newborns and macrosomic babies (≥4 kg).

Results

Among the singleton term live births (37 weeks onward) we could define the pre-pregnancy body mass index and GWG in 85.9% of cases. The final study population focused on 10,296 obese women (7138 obesity class I − 30–34.9 kg/m², 3158 obesity class II – 35–39.9 kg/m²). Concerning inadequate GWG (less than 5 kg), respectively for obese I and II, IOMR babies were heavier (plus 90 and 104 g, p < .001), were more prone to be LGA OR 1.61 and 1.69, p < .001, macrosomic OR 1.49 and 2.21, p < .0001, IOMR women had more cesarean sections OR 1.33, OR 1.45, p = .001, and for obese II a tendency for more term preeclampsia OR 1.83, p = .06.

Conclusion

This study demonstrates that for obese women these IOMR (5–9 kg) are mildly but significantly too high if we consider obesity class I and obviously too high for obesity class II (35–39.9 kg/m²).

Keywords:

• Pregnancy
• epidemiology
• pre-pregnancy body mass index
• gestational weight gain
• cesarean section
• obesity
• preeclampsia

Disclosure statement

The author attests that no conflict of interest exists regarding this work.

Condensation

International recommendations (IOM 2009): 5–9 kg of gestational weight gain in obese women class I and II are too high.

Additional information

Funding

No specific funding besides the French Government funding for the South-Reunion perinatal database.