Impact of Low Gestational Weight Gain on Adverse Pregnancy Outcomes amongWomen with Class II Obesity: A Prospective Cohort Study in Baharestan County,Iran

The present study aimed to investigate the association between low gestational weight gain (GWG) andadverse pregnancy outcomes among women with Class II obesity (BMI ۳۵-۳۹.۹ kg/m۲) in BaharestanCounty, Iran. A prospective cohort design was employed, including ۳۰ pregnant women who werefollowed throughout their pregnancies. Participants were categorized into three GWG groups based onthe Institute of Medicine (IOM) guidelines: low GWG, adequate GWG, and excessive GWG. Theprimary outcomes assessed were preterm birth, cesarean delivery, large for gestational age (LGA), andsmall for gestational age (SGA). Secondary outcomes included preeclampsia, gestational diabetes,postpartum hemorrhage, and neonatal morbidity. The study found that women with low GWG had asignificantly higher incidence of preterm birth (۳۳.۳%), cesarean delivery (۵۵.۶%), and SGA infants(۲۲.۲%) compared to those with adequate or excessive GWG. Additionally, the low GWG group hadhigher rates of preeclampsia (۲۲.۲%), postpartum hemorrhage (۱۱.۱%), and neonatal morbidity(۲۲.۲%). Conversely, the excessive GWG group had a higher prevalence of LGA infants (۳۳.۳%) butlower rates of some adverse outcomes compared to the low GWG group. These findings suggest thatlow GWG in women with Class II obesity is associated with an increased risk of adverse pregnancyoutcomes. The study highlights the importance of achieving appropriate GWG to minimize these risks.However, the small sample size limits the generalizability of the results, and further research with larger,more diverse populations is needed to confirm these associations and explore the potential influence ofsocioeconomic, cultural, and environmental factors on GWG patterns and pregnancy outcomes.

Keywords:

Low gestational weight gain , adverse pregnancy outcomes , class II obesity , obstetrics , prospective cohort study