Table 2.
Association of GWG below and above the 2009 IOM recommendations with adverse pregnancy outcomes.
| BMI group | Outcomes | Rate of outcome | Risk of outcome | ||||
|---|---|---|---|---|---|---|---|
| GWG below IOM | GWG within IOM | GWG above IOM | P-value | GWG below VS within IOM | GWG above VS within IOM | ||
| aOR (95%CI) | aOR (95%CI) | ||||||
| Normal weight | Cesarean delivery | 41 (44.09) | 40 (48.78) | 21 (63.64) | 0.155 | 0.77 (0.41, 1.46) | 1.57 (0.65, 3.78) |
| Assisted vaginal delivery | 7 (7.53) | 6 (7.32) | 2 (6.06) | 0.961 | 1.34 (0.39, 4.68) | 0.78 (0.13, 4.67) | |
| Vaginal delivery | 45 (48.39) | 36 (43.90) | 10 (30.30) | 0.198 | 1.19 (0.63, 2.23) | 0.66 (0.26, 1.64) | |
| Gestational hypertension | 6 (6.45) | 9 (10.98) | 5 (15.15) | 0.300 | 0.57 (0.18, 1.85) | 1.19 (0.34, 4.24) | |
| Preeclampsia | 4 (4.30) | 9 (10.98) | 3 (9.09) | 0.241 | 0.18 (0.04, 0.82)b | 0.53 (0.12, 2.34) | |
| PROM | 29 (31.18) | 21 (25.61) | 7 (21.21) | 0.488 | 1.22 (0.61, 2.42) | 0.89 (0.32, 2.42) | |
| Preterm birth | 9 (9.68) | 7 (8.54) | 1 (3.03) | 0.482 | / | / | |
| Postpartum hemorrhage | 10 (10.75) | 12 (14.63) | 4 (12.12) | 0.739 | 0.74 (0.29, 1.90) | 0.88 (0.25, 3.12) | |
| Macrosomia | 6 (6.45) | 12 (14.63) | 8 (6.45) | 0.022b | 0.38 (0.12, 1.21) | 3.09 (0.91, 10.44) | |
| Small for gestational age | 3 (3.23) | 3 (3.66) | 1 (3.03) | 1a | 0.74 (0.11, 4.84) | 0.96 (0.06, 14.49) | |
| Large for gestational age | 9 (9.68) | 15 (18.29) | 12 (36.36) | 0.002b | 0.38 (0.14, 1.03) | 4.56 (1.54, 13.46)b | |
| Neonatal hypoglycemia | 8 (20.73) | 17 (20.73) | 7 (21.21) | 0.051 | 0.38 (0.15, 0.97)b | 0.89 (0.30, 2.63) | |
| Neonatal jaundice | 8 (8.60) | 9 (10.98) | 4 (12.12) | 0.799 | 0.77 (0.25, 2.33) | 1.09 (0.28, 4.30) | |
| NRDS | 8 (8.60) | 5 (6.10) | 3 (8.60) | 0.782 | 1.24 (0.30, 5.20) | 2.54 (0.44, 14.71) | |
| NICU admission | 18 (19.35) | 19 (23.17) | 8 (24.24) | 0.767 | 0.63 (0.27, 1.51) | 0.97 (0.33, 2.80) | |
| Overweight | Cesarean delivery | 36 (53.73) | 61 (55.96) | 61 (73.49) | 0.017b | 0.87 (0.45, 1.67) | 1.71 (0.88, 3.33) |
| Assisted vaginal delivery | 3 (4.48) | 8 (7.34) | 6 (7.23) | 0.725 | 0.49 (0.11, 2.15) | 1.07 (0.31, 3.71) | |
| Vaginal delivery | 28 (41.79) | 40 (36.70) | 16 (19.28) | 0.006b | 1.34 (0.69, 2.59) | 0.54 (0.26, 1.11) | |
| Gestational hypertension | 4 (5.97) | 12 (11.01) | 14 (16.87) | 0.113 | 0.42 (0.12, 1.40) | 2.36 (0.92, 6.05) | |
| Preeclampsia | 9 (13.43) | 11 (10.09) | 12 (13.43) | 0.629 | 1.30 (0.48, 3.53) | 1.34 (0.51, 3.57) | |
| PROM | 19 (25.69) | 28 (25.69) | 18 (21.69) | 0.634 | 1.02 (0.50, 2.07) | 0.73 (0.35, 1.52) | |
| Preterm birth | 10 (11.93) | 13 (11.93) | 10 (12.05) | 0.823 | / | / | |
| Postpartum hemorrhage | 6 (8.96) | 23 (21.10) | 15 (18.07) | 0.108 | 0.38 (0.14, 1.02) | 0.66 (0.29, 1.47) | |
| Macrosomia | 10 (14.93) | 17 (15.60) | 17 (14.93) | 0.586 | 0.90 (0.36, 2.26) | 1.78 (0.76, 4.19) | |
| Small for gestational age | 4 (5.97) | 3 (2.75) | 0 | 0.057a | 3.07 (0.53, 17.64) | / | |
| Large for gestational age | 11 (16.42) | 20 (18.35) | 22 (26.51) | 0.242 | 0.83 (0.35 1.97) | 1.91 (0.86, 4.24) | |
| Neonatal hypoglycemia | 7 (10.45) | 16 (14.68) | 15 (18.07) | 0.423 | 0.69 (0.26, 1.82) | 1.10 (0.47, 2.58) | |
| Neonatal jaundice | 10 (14.93) | 18 (16.51) | 14 (16.87) | 0.944 | 0.88 (0.37, 2.13) | 0.90 (0.39, 2.07) | |
| NRDS | 7 (10.45) | 10 (9.17) | 8 (9.64) | 0.962 | 0.87 (0.25, 3.02) | 0.70 (0.20, 2.38) | |
| NICU admission | 24 (35.82) | 31 (28.44) | 29 (34.94) | 0.501 | 1.17 (0.57, 2.40) | 1.25 (0.60, 2.60) | |
| Obese | Cesarean delivery | 34 (58.62) | 54 (67.50) | 60 (80.00) | 0.026b | 0.57 (0.27, 1.22) | 1.56 (0.72, 3.37) |
| Assisted vaginal delivery | 4 (6.90) | 4 (5.00) | 1 (1.33) | 0.285a | 1.88 (0.37, 9.49) | 0.37 (0.04, 3.74) | |
| Vaginal delivery | 20 (34.48) | 22 (27.50) | 14 (18.67) | 0.115 | 1.57 (0.72, 3.41) | 0.73 (0.33, 1.61) | |
| Gestational hypertension | 3 (5.17) | 9 (11.25) | 8 (10.67) | 0.431 | 0.45 (0.11, 1.87) | 1.17 (0.39, 3.46) | |
| Preeclampsia | 5 (8.62) | 9 (11.25) | 16 (21.33) | 0.074 | 0.73 (0.21, 2.58) | 2.74 (1.02, 7.38)b | |
| PROM | 14 (24.14) | 16 (20.00) | 15 (20.00) | 0.805 | 1.60 (0.68, 3.78) | 0.97 (0.43, 2.20) | |
| Preterm birth | 9 (15.52) | 14 (17.50) | 11 (14.67) | 0.885 | / | / | |
| Postpartum hemorrhage | 10 (17.24) | 11 (13.75) | 11 (14.67) | 0.847 | 1.12 (0.43, 2.95) | 1.15 (0.45, 2.92) | |
| Macrosomia | 3 (5.17) | 16 (20.00) | 22 (29.33) | 0.002b | 0.18 (0.05, 0.69)b | 1.76 (0.77, 4.02) | |
| Small for gestational age | 3 (5.17) | 0 | 3 (4.00) | 0.111a | / | / | |
| Large for gestational age | 4 (6.90) | 21 (26.25) | 29 (38.67) | <0.001b | 0.19 (0.06, 0.60)b | 1.70 (0.82, 3.56) | |
| Neonatal hypoglycemia | 9 (15.52) | 14 (17.50) | 14 (18.67) | 0.892 | 0.80 (0.30, 2.11) | 0.87 (0.37, 2.05) | |
| Neonatal jaundice | 7 (12.07) | 12 (15.00) | 4 (5.33) | 0.143 | 0.76 (0.26, 2.22) | 0.35 (0.10, 1.19) | |
| NRDS | 6 (10.34) | 7 (8.75) | 6 (8.00) | 0.893 | 1.55 (0.40, 6.02) | 1.15 (0.30, 4.46) | |
| NICU admission | 19 (32.76) | 21 (26.25) | 24 (32.00) | 0.642 | 1.47 (0.62, 3.48) | 1.11 (0.50, 2.44) | |
Values are expressed as number (percentage). GWG, gestational weight gain; IOM, Institute of Medicine; BMI, body mass index; aOR, adjusted odds ratio; CI, confidence interval; PROM, premature rupture of membranes; NRDS, neonatal respiratory distress syndrome; NICU, neonatal intensive care unit; aFisher exact test; bSignificant associations.