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Am J Perinatol 2015; 32(07): 615-620
DOI: 10.1055/s-0034-1386634
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Influence of Gestational Weight Gain on the Development of Gestational Hypertension in Obese Women

John R. Barton
1   Perinatal Diagnostic Center, Baptist Health Lexington, Lexington, Kentucky
,
Saju D. Joy
2   Department of Maternal-Fetal Medicine, Carolinas Medical Center, Charlotte, North Carolina
,
Debbie J. Rhea
3   Department of Clinical Research, Alere Women's and Children's Health, Atlanta, Georgia
,
Amanda J. Sibai
4   College of Charleston, Charleston, South Carolina
,
Baha M. Sibai
5   Department of Obstetrics and Gynecology, University of Texas Medical School at Houston, Houston, Texas
› Author Affiliations
Further Information

Publication History

24 March 2014

18 June 2014

Publication Date:
08 December 2014 (online)

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Abstract

Objective The objective of this study was to examine the influence of gestational weight gain on the development of gestational hypertension/preeclampsia (GHTN/PE) in women with an obese prepregnancy body mass index (BMI).

Methods Obese women with a singleton pregnancy enrolled at < 20 weeks were studied. Data were classified according to reported gestational weight gain (losing weight, under-gaining, within target, and over-gaining) from the recommended range of 11 to 9.7 kg and by obesity class (class 1 = BMI 30–34.9 kg/m2, class 2 = 35–39.9 kg/m2, class 3 = 40–49.9 kg/m2, and class 4 ≥ 50 kg/m2). Rates of GHTN/PE were compared by weight gain group overall and within obesity class using Pearson chi-square statistics.

Results For the 27,898 obese women studied, rates of GHTN/PE increased with increasing class of obesity (15.2% for class 1 and 32.0% for class 4). The incidence of GHTN/PE in obese women was not modified with weight loss or weight gain below recommended levels. Overall for obese women, over-gaining weight was associated with higher rates of GHTN/PE compared with those with a target rate for obesity classes 1 to 3 (each p < 0.001).

Conclusion Below recommended gestational weight gain did not reduce the risk for GHTN/PE in women with an obese prepregnancy BMI. These data support a gestational weight gain goal ≤ 9.7 kg in obese gravidas.

Keywords

gestational hypertension - preeclampsia - obesity - weight gain

Note

This study was presented at the XVIII World Congress of the International Society for the Study of Hypertension in Pregnancy. July 9–12, 2012. Geneva, Switzerland.


 

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