185: Neonatal and Maternal Outcomes Associated with Limited Gestational Weight Gain among Obese Pregnant Women

We evaluated the effect of minimal weight gain or weight loss during pregnancy on maternal and neonatal outcomes among obese women. In a large health maintenance organization, we conducted a retrospective cohort study of 12,700 women who delivered a term, singleton, liveborn infant between 2000 and 2005. Obesity was defined as BMI ≥30 kg/m2 (n=3,047, 24%). Total weight gain (last available - first available antenatal weight) was categorized as <0, 0-15, and ≥15 lbs. Maternal and neonatal outcomes were identified through electronic medical records and by ICD-9 and DRG codes. Overall, mean weight gain was 24.5 lbs (range −57.8 to 98.0). Five percent of obese women lost weight during pregnancy (mean −6.9 lbs, SD 7.2), 24% gained 0-15 lbs (mean 9.2 lbs, SD 4.3), and 71% gained ≥15 lbs (mean 31.6 lbs, SD 12.3). The table demonstrates maternal and neonatal outcomes by weight change category. In this population, minimal weight gain or weight loss during pregnancy was associated with lower risks of hypertensive disorders of pregnancy and macrosomia; whereas other measures of adverse outcomes were not significantly different.