581: Excess gestational weight gain is associated with gestational hypertension/preeclampsia and cesarean birth

ObjectiveTo evaluate the association between the newly recommended, Institute of Medicine (IOM) guidelines for gestational weight gain and adverse pregnancy outcomes using a large administrative database.Study DesignRetrospective cohort study of California women delivering singleton gestations in the year 2007, using linked birth certificate and discharge diagnosis data (California Maternity Quality Care Collaborative Data Set). The association between gestational weight gain and adverse pregnancy outcomes, including gestational diabetes (GDM), gestational hypertension/preeclampsia (PIH), preterm birth (PTB), Apgar score <7 at 5 minutes, and cesarean delivery (CD), were evaluated. The Cochrane Mantel Haenszel test was used for categorical comparisons. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI). Women having the recommended gestational weight gain served as the reference group for the regression analyses.ResultsThe study population consisted of 398,488 women. Compared to women with the recommended weight gain, weight gain above IOM guidelines was associated with a higher odds of PIH (OR=1.7, 95% CI=1.66-1.77) and CD (1.43, 1.40-1.47) but a lower odds of GDM (0.9, 0.89-0.95) and PTB (0.8, 0.76-0.81). In contrast, weight gain below IOM guidelines was associated with a lower odds of PIH (0.9, 0.87-0.96) and CD (0.89, 0.86-0.92) but a higher odds of GDM (1.5, 1.43-1.53) and PTB (1.5, 1.46-1.55).Conclusions ObjectiveTo evaluate the association between the newly recommended, Institute of Medicine (IOM) guidelines for gestational weight gain and adverse pregnancy outcomes using a large administrative database. To evaluate the association between the newly recommended, Institute of Medicine (IOM) guidelines for gestational weight gain and adverse pregnancy outcomes using a large administrative database. Study DesignRetrospective cohort study of California women delivering singleton gestations in the year 2007, using linked birth certificate and discharge diagnosis data (California Maternity Quality Care Collaborative Data Set). The association between gestational weight gain and adverse pregnancy outcomes, including gestational diabetes (GDM), gestational hypertension/preeclampsia (PIH), preterm birth (PTB), Apgar score <7 at 5 minutes, and cesarean delivery (CD), were evaluated. The Cochrane Mantel Haenszel test was used for categorical comparisons. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI). Women having the recommended gestational weight gain served as the reference group for the regression analyses. Retrospective cohort study of California women delivering singleton gestations in the year 2007, using linked birth certificate and discharge diagnosis data (California Maternity Quality Care Collaborative Data Set). The association between gestational weight gain and adverse pregnancy outcomes, including gestational diabetes (GDM), gestational hypertension/preeclampsia (PIH), preterm birth (PTB), Apgar score <7 at 5 minutes, and cesarean delivery (CD), were evaluated. The Cochrane Mantel Haenszel test was used for categorical comparisons. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI). Women having the recommended gestational weight gain served as the reference group for the regression analyses. ResultsThe study population consisted of 398,488 women. Compared to women with the recommended weight gain, weight gain above IOM guidelines was associated with a higher odds of PIH (OR=1.7, 95% CI=1.66-1.77) and CD (1.43, 1.40-1.47) but a lower odds of GDM (0.9, 0.89-0.95) and PTB (0.8, 0.76-0.81). In contrast, weight gain below IOM guidelines was associated with a lower odds of PIH (0.9, 0.87-0.96) and CD (0.89, 0.86-0.92) but a higher odds of GDM (1.5, 1.43-1.53) and PTB (1.5, 1.46-1.55). The study population consisted of 398,488 women. Compared to women with the recommended weight gain, weight gain above IOM guidelines was associated with a higher odds of PIH (OR=1.7, 95% CI=1.66-1.77) and CD (1.43, 1.40-1.47) but a lower odds of GDM (0.9, 0.89-0.95) and PTB (0.8, 0.76-0.81). In contrast, weight gain below IOM guidelines was associated with a lower odds of PIH (0.9, 0.87-0.96) and CD (0.89, 0.86-0.92) but a higher odds of GDM (1.5, 1.43-1.53) and PTB (1.5, 1.46-1.55). Conclusions