In a clinical trial, investigators aimed to determine the optimal gestational weight gain for women with obesity to minimize the risk for neonatal and maternal adverse events. The study included women with obesity who delivered a full-term singleton in a head-down position. The primary outcome was a composite risk of significant neonatal morbidity, while secondary outcomes included combined risks of substantial maternal morbidity, minor neonatal and maternal morbidity, and cesarean delivery.
The study's results indicated that among the 16,808 eligible women with obesity, the optimal gestational weight change for all women was -1 to +4 kg. This weight change was associated with a reduced risk of significant neonatal morbidity compared to the current recommendations.
Researchers also analyzed the data based on the class of obesity. Individuals with a body mass index (BMI) between 30 and 35 are classified as class 1 obesity, while those with a BMI between 35 and 40 are classified as class 2 obesity. Class 3 obesity, on the other hand, includes individuals with a BMI of 40 or higher and is sometimes referred to as "severe" obesity. A weight change of -1 to +4 kg for class I, -2 to +2 for class II, and -2 to +3 kg for class III was associated with a reduced risk of significant neonatal morbidity.
The study concluded that a gestational weight change of -1 to +4 kg is associated with a reduced risk of adverse perinatal outcomes compared with the current guidelines. Women with class I obesity showed similar findings, while women with class II or III obesity could benefit from a lower weight gain.
These findings are significant as obesity during pregnancy has been associated with increased risks of adverse maternal and neonatal outcomes, including gestational diabetes, hypertensive disorders, and cesarean delivery. By identifying an optimal gestational weight gain interval, healthcare providers can better advise women with obesity on appropriate weight gain during pregnancy to minimize risks.
Overall, this study highlights the importance of maintaining a healthy weight during pregnancy, particularly for women with obesity, and emphasizes the need for personalized and tailored guidance on gestational weight gain to minimize adverse outcomes.