Association between Gestational Weight Gain and Pregnancy Outcomes in Various Body Mass Index Groups: A Retrospective Observational Study

Abstract Introduction: Body mass index (BMI) has been known to be an important determinant of pregnancy morbidities. However, multiple studies show that the effects are equally dependent on the gestational weight gain (GWG). There is a lack of data in the Indian population, especially using the Asia–Pacific guidelines of BMI. This study is meant to identify the degree of association between the GWG in different BMIs and the development of pregnancy morbidities. Materials and Methods: This was a retrospective study, in which case records of women who delivered in our hospitals during 1 year were analyzed. Pregnancy outcomes, such as growth restriction, preterm deliveries, development of hypertensive disorders, gestational diabetes, inductions, and cesareans, were analyzed in three classes of GWG inadequate, adequate, and excess GWG (as per institue of medicine guidelines). The Chi-square test was done to see the difference in the pregnancy outcomes. Results: Of the 1396 women enrolled, women with inadequate GWG had higher preterm deliveries (13.8% vs. 4.4%, P < 0.001) and fetal growth restriction (8.8% vs. 3.9%, P = 0.003) with higher odds in underweight women with inadequate GWG (odds ratio [OR] of 2.6 and 1.75, respectively). Excess GWG had a significantly higher induction (34.9% vs. 29%, P > 0.05) and cesarean delivery rate (34.3% vs. 21.6%, P = 0.003) with higher odds seen in obese women with excess GWG (OR of 2.6 and 1.75, respectively). Conclusion: All women having out-of-range BMI should be identified during the first antenatal contact. Inadequate GWG in underweight women and excess GWG in obese women should be strictly monitored and targeted to prevent a wide spectrum of maternal morbidities.