Menu Close

Severe Obesity, Gestational Weight Gain, and Adverse Birth Outcomes


Bodnar, Lisa Marie; Siega-Riz, Anna Maria; Simhan, Hyagriv N.; Himes, Katherine P.; & Abrams, Barbara F. (2010). Severe Obesity, Gestational Weight Gain, and Adverse Birth Outcomes. American Journal of Clinical Nutrition, 91(6), 1642-1648. PMCID: PMC2869513


BACKGROUND: The 2009 Institute of Medicine (IOM) Committee to Reevaluate Gestational Weight Gain Guidelines concluded that there were too few data to inform weight-gain guidelines by obesity severity. Therefore, the committee recommended a single range, 5-9 kg at term, for all obese women.
OBJECTIVE: We explored associations between gestational weight gain and small-for-gestational-age (SGA) births, large-for-gestational-age (LGA) births, spontaneous preterm births (sPTBs), and medically indicated preterm births (iPTBs) among obese women who were stratified by severity of obesity.
DESIGN: We studied a cohort of singleton, live-born infants without congenital anomalies born to obesity class 1 (prepregnancy body mass index [BMI (in kg/m(2))]: 30-34.9; n = 3254), class 2 (BMI: 35-39.9; n = 1451), and class 3 (BMI: >/=40; n = 845) mothers. We defined the adequacy of gestational weight gain as the ratio of observed weight gain to IOM-recommended gestational weight gain.
RESULTS: The prevalence of excessive gestational weight gain declined, and weight loss increased, as obesity became more severe. Generally, weight loss was associated with an elevated risk of SGA, iPTB, and sPTB, and a high weight gain tended to increase the risk of LGA and iPTB. Weight gains associated with probabilities of SGA and LGA of CONCLUSION: These data suggest that the range of gestational weight gain to balance risks of SGA, LGA, sPTB, and iPTB may vary by severity of obesity.


Reference Type

Journal Article

Year Published


Journal Title

American Journal of Clinical Nutrition


Bodnar, Lisa Marie
Siega-Riz, Anna Maria
Simhan, Hyagriv N.
Himes, Katherine P.
Abrams, Barbara F.