Impact of excessive weight gain and pre-gestational obesity on maternal and neonatal outcomes

Excessive gestational weight gain and prepregnancy obesity have been associated with adverse maternal and neonatal outcomes, although their associations with specific pregnancy outcomes may differ. This retrospective, cross-sectional study included 972 women who delivered at a public referral hospital in Brazil. Maternal and neonatal data were obtained from electronic medical records. Continuous and categorical variables were compared using appropriate statistical tests, and multivariable logistic regression analyses were performed to evaluate the associations between excessive gestational weight gain, prepregnancy obesity, and maternal and neonatal outcomes after adjustment for maternal age, chronic hypertension, diabetes mellitus, and smoking status. After adjustment, excessive gestational weight gain remained associated with cesarean delivery and macrosomia, whereas prepregnancy obesity remained associated with gestational hypertension or preeclampsia and cesarean delivery. These findings suggest that prepregnancy obesity and excessive gestational weight gain are associated with distinct patterns of maternal and neonatal outcomes. Strategies aimed at optimizing maternal weight before conception and promoting gestational weight gain within recommended ranges may help improve maternal and neonatal outcomes.