Gestational weight management in women with class III obesity : associations with obstetric and perinatal outcomes - 15/12/25
Highlights |
• | In women with class III obesity, exceeding gestational weight gain (GWG) recommendations was not significantly associated with mode of delivery. |
• | Non-excess GWG was linked to shorter labor duration, reduced postpartum hemorrhage, and lower birthweight. |
• | Adherence to GWG guidelines significantly decreased the risk of large-for-gestational-age (LGA) neonates. |
• | Nutritional follow-up was insufficiently implemented and often limited to high-risk patients with gestational diabetes, reflecting indication bias.Findings support structured and individualized nutritional counseling, alongside strict GWG management, to optimize maternal and neonatal outcomes in class III obesity. |
Abstract |
Background |
Class III obesity is associated with increased maternal and neonatal complications. Gestational weight gain (GWG) is a modifiable factor that may influence these outcomes, but evidence in women with severe obesity remains limited.
Purpose |
To evaluate the impact of GWG adherence to the Institute of Medicine (IOM) and Journal of the American Medical Association (JAMA) recommendations on obstetric and neonatal outcomes in women with class III obesity, and to explore the role of nutritional follow-up.
Methods |
Retrospective, single-center cohort study including women with class III obesity who delivered a singleton at the University Hospital of Reims, France. Women were classified according to whether they exceeded GWG recommendations from IOM (≤9 kg) and JAMA (<6 kg), and by receipt of nutritional counseling. The primary outcome was mode of delivery. Secondary outcomes included maternal, obstetric, and neonatal morbidity.
Main findings |
Among 300 women, exceeding GWG recommendations was not significantly associated with mode of delivery (IOM p=0.23; JAMA p=0.27). Non-excessive GWG was associated with shorter labor (IOM: 260 vs. 401.5 min, p<0.001), reduced postpartum hemorrhage (IOM: ORa 0.44; 95% CI: 0.20–0.98; p=0.044), lower birthweight, and decreased risk of LGA neonates (IOM: ORa 0.31; 95% CI: 0.11–0.85; p=0.024). Nutritional follow-up was limited, with few women receiving structured guidance.
Conclusions |
In women with class III obesity, non-excessive GWG according to recommendations does not appear to affect the mode of delivery. It seems to be associated with shorter labor and a lower risk of macrosomia.
Le texte complet de cet article est disponible en PDF.Keywords : Obesity, Pregnancy weight gain, Practice guidelines as topic, Patient compliance, Labor, Obstetric, Pregnancy outcome
Plan
Vol 55 - N° 2
Article 103082- février 2026 Retour au numéro
Article précédent
- Ultrasound-indicated versus systematic intrauterine manual examination in the management of postpartum hemorrhage: a before-and-after study
- Anne-Sophie Boucherie, Agnès Villart, Paul Berveiller, Patrick Rozenberg, Anne Rousseau, Thibaud Quibel
- Contribution of simulation in gynecological ultrasound in resident’s training
- Hélène Creton de Limerville, Leila Bouazzi, Coralie Barbe, Isabelle Célerier, Amélie Fouchet, Marie Boiteux-Chabrier, René Gabriel, Olivier Graesslin, Emilie Raimond
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?