Evaluation of Institute of Medicine Guidelines for Gestational Weight Gain in Women with Chronic Hypertension

Anne M. Siegel; Alan T. Tita; Hannah Machemehl; Joseph R. Biggio; Lorie M. Harper

doi:10.1055/s-0037-1604076

American Journal of Perinatology Reports, Inhaltsverzeichnis

CC-BY-NC-ND 4.0 · AJP Rep 2017; 07(03): e145-e150
DOI: 10.1055/s-0037-1604076

Case Report

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Evaluation of Institute of Medicine Guidelines for Gestational Weight Gain in Women with Chronic Hypertension

Anne M. Siegel

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health at the University of Alabama at Birmingham, Birmingham, Alabama

,

Alan T. Tita

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health at the University of Alabama at Birmingham, Birmingham, Alabama

,

Hannah Machemehl

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health at the University of Alabama at Birmingham, Birmingham, Alabama

,

Joseph R. Biggio

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health at the University of Alabama at Birmingham, Birmingham, Alabama

,

Lorie M. Harper

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health at the University of Alabama at Birmingham, Birmingham, Alabama

› Institutsangaben

Abstract

Objective To assess the impact of gestational weight gain (GWG) outside the Institute of Medicine (IOM) recommendations on perinatal outcomes in pregnancies complicated by chronic hypertension (HTN).

Methods The study consisted of a retrospective cohort of all singletons with HTN from 2000 to 2014. Maternal outcomes examined were superimposed preeclampsia and cesarean delivery. Neonatal outcomes were small for gestational age (SGA), large for gestational age (LGA), and preterm birth (PTB). Groups were compared using analysis of variance and chi-squared test for trend. Backward stepwise logistic regression was adjusted for confounding factors.

Results Of 702 subjects, 106 (15.1%) gained within, 176 (25.0%) gained less, and 420 (59.8%) gained more weight than the IOM recommendations. After adjusting for confounders, GWG above IOM recommendations remained associated with LGA (adjusted odds ratio [AOR]: 2.53, confidence interval [CI] 95%:1.29–4.95). Weight gain less than recommended was associated with a decreased risk of superimposed preeclampsia (AOR: 0.49, CI 95%: 0.26–0.93) without increasing the risk of SGA (AOR: 1.03, CI 95%: 0.57–1.86).

Conclusion Women with pregnancies complicated by chronic HTN should be counseled regarding the association of LGA with excessive GWG. Additionally, they should be counseled that weight gain below recommendations may be associated with a decreased risk of superimposed preeclampsia; however, this association deserves further investigation.

Keywords

hypertension - gestational weight gain - preeclampsia - pregnancy

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Referenzen

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