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Table 2 Gestational weight gain outside versus within the Institute of Medicine recommendations (2009) and the adverse pregnancy outcomes

From: Gestational weight gain outside the Institute of Medicine recommendations and adverse pregnancy outcomes: analysis using individual participant data from randomised trials

BMI category No. studies (women) OR (95% CI) No. studies (women) aOR (95% CI) No. studies (women) OR (95% CI) No. studies (women) aOR (95% CI)
  Gestational weight gain above the IOM recommendations
Caesarean sectiona Preterm birthb
All womene 30 (2727) 1.42 (1.20, 1.68) 24 (2700) 1.50 (1.25, 1.80) 30 (3126) 0.75 (0.50, 1.11) 26 (2769) 0.84 (0.54, 1.29)
Healthy BMIf (16 kg) 21 (949) 1.36 (0.96, 1.92) 21 (781) 1.58 (1.09, 2.28) 21 (971) 1.40 (0.70, 2.80) 19 (809) 1.73 (0.82, 3.65)
Overweight (11.5 kg) 29 (982) 1.43 (1.04, 1.98) 23 (877) 1.68 (1.19, 2.35) 29 (1000) 0.32 (0.15, 0.68) 25 (897) 0.40 (0.18, 0.86)
Obese (9 kg) 30 (1143) 1.29 (1.00, 1.68) 24 (1042) 1.44 (1.10, 1.89) 30 (1155) 0.81 (0.41, 1.59) 26 (1063) 0.89 (0.44, 1.80)
  Large for Gestational Agec Small for Gestational Aged
All womene 31 (3138) 1.85 (1.47, 2.32) 30 (3123) 2.00 (1.58, 2.54) 30 (3123) 0.68 (0.52, 0.87) 25 (2754) 0.66 (0.50, 0.87)
Healthy BMI (16 kg) 21 (973) 1.77 (1.17, 2.70) 20 (967) 1.68 (1.10, 2.56) 21 (970) 0.89 (0.54, 1.44) 18 (803) 0.93 (0.56, 1.56)
Overweight (11.5 kg) 29 (1003) 1.68 (1.11, 2.53) 28 (998) 1.83 (1.20, 2.80) 29 (1000) 0.44 (0.27, 0.74) 24 (897) 0.51 (0.30, 0.87)
Obese (9 kg) 31 (1162) 2.53 (1.67, 3.83) 30 (1158) 2.75 (1.80, 4.19) 30 (1153) 0.71 (0.48, 1.05) 25 (1054) 0.65 (0.42, 0.98)
  Gestational weight gain below the IOM recommendations
Caesarean sectiona Preterm birthb
All womene 30 (3074) 0.93 (0.76, 1.13) 24 (2395) 0.93 (0.75, 1.13) 30 (2769) 1.81 (1.26, 2.59) 26 (2486) 1.94 (1.31, 2.88)
Healthy BMI (11.5 kg) 21 (1285) 0.84 (0.60, 1.17) 21 (1082) 0.79 (0.55, 1.14) 21 (1309) 1.69 (0.95, 3.01) 19 (1131) 1.65 (0.86, 3.17)
Overweight (7 kg) 29 (590) 0.99 (0.65, 1.51) 23 (536) 0.83 (0.53, 1.31) 29 (601) 1.28 (0.62, 2.64) 25 (562) 1.58 (0.73, 3.43)
Obese (5 kg) 30 (852) 1.07 (0.80, 1.43) 24 (777) 1.10 (0.81, 1.51) 30 (859) 2.40 (1.28, 4.50) 26 (793) 2.39 (1.22, 4.68)
  Large for Gestational Agec Small for Gestational Aged
All womene 31 (2783) 0.79 (0.59, 1.05) 30 (5880) 0.76 (0.57, 1.02) 30 (2762) 1.57 (1.24, 2.00) 25 (2446) 1.52 (1.18, 1.96)
Healthy BMI (11.5 kg) 21 (1312) 0.77 (0.50, 1.18) 20 (1294) 0.78 (0.51, 1.20) 21 (1304) 1.71 (1.16, 2.51) 18 (1113) 1.62 (1.07, 2.45)
Overweight (7 kg) 29 (604) 0.54 (0.28, 1.02) 28 (599) 0.53 (0.27, 1.02) 29 (601) 1.24 (0.74, 2.09) 24 (549) 1.24 (0.71, 2.16)
Obese (5 kg) 31 (467) 1.03 (0.62, 1.74) 30 (864) 0.98 (0.58, 1.66) 30 (857) 1.82 (1.24, 2.66) 25 (784) 1.81 (1.22, 2.71)
  1. BMI Body Mass Index (kg/m2), OR Odds ratio, aOR Adjusted odds ratio, CI Confidence intervals, IOM Institute of Medicine
  2. Models adjustments aAny event of diabetes, age, gestational age at delivery, parity, smoking; bSmoking; cAny event of diabetes, and woman’s age; dSmoking, woman’s age, and parity; and BMI category; eAll relevant confounders and BMI category; statistically significant associations are in bold
  3. Kilogram values in brackets indicate upper (weight gain above) or lower (weight gain below) value of the IOM recommendations (2009) for a given BMI category [20]
  4. fequivalent of BMI termed as normal in the World Health Organization classification [20]