(818) The Association Between Excessive Gestational Weight Gain in Obese Patients and Intrapartum and Postpartum Outcomes

Friday, January 31, 2025

10:30 AM – 12:30 PM

Submitting Author and Presenting Author(s)

Lauren M. Silva, MD

Fellow
University of Florida College of Medicine
Gainesville, FL, United States

Coauthor(s)

CR

Caitlin Rogers, MD

Fellow
University of Florida College of Medicine
Gainesville, Florida, United States
EA

Emily Astarita

Medical Student
University of Florida College of Medicine
Gainesville, Florida, United States
DM

Divya Mahesh

Medical Student
University of Florida College of Medicine
Gainesville, Florida, United States
PC

Payton Campbell

Medical Student
University of Florida College of Medicine
Gainesville, Florida, United States
DS

Danielle Snyder

Medical Student
University of Florida College of Medicine
Gainesville, Florida, United States
ND

Nicole Diaz

Medical Student
University of Florida College of Medicine
Gainesville, Florida, United States
AE

Aniela Edwards

Medical Student
University of Florida College of Medicine
Gainesville, Florida, United States
CL

Caroline Lamoutte, MD

Resident
St. Louis University School of Medicine
St. Louis, Missouri, United States
RH

Rebecca Henderson, MD, PhD

Resident
University of Alabama School of Medicine
Gainesville, Florida, United States
KH

Khanh Huynh, MD

Resident
University of Florida College of Medicine
Gainesville, Florida, United States
TR

Thomas Reilly

Medical Student
University of Florida College of Medicine
Gainesville, Florida, United States
MG

Matthew Gurka, PhD

Professor
University of Virginia School of Medicine
Charlottesville, Virginia, United States
TW

Tony Wen, MD

Professor
University of Florida College of Medicine
Gainesville, Florida, United States
AL

Adetola F. Louis-Jacques, MD

Assistant Professor
University of Florida
Gainesville, Florida, United States

Objective: Obese women have a longer duration of labor, particularly those undergoing induction of labor (IOL), and higher rates of adverse outcomes. This study aimed to determine the length of the latent phase, total induction time, and frequencies of cesarean delivery and adverse outcomes in obese patients with excessive weight gain (EWG) compared to those with appropriate weight gain (AWG) undergoing IOL.

Study Design: Retrospective cohort study including nulliparous patients with a BMI > 30 kg/m2 that underwent IOL at a single academic institution between June 2018 and December 2022. Gestational weight gain was calculated based on the difference between pre-pregnancy or first trimester weight and weight at delivery, then categorized as AWG or EWG based on recommendations by the Institute of Medicine. The IOL lengths and frequencies of the outcomes of interest (Table 2) were extracted from the electronic medical record. Chi square, t-test, and Wilcoxon rank sum test were performed where appropriate.

Results: Of 469 obese patients, 105 (22.4%) had AWG and 364 (77.6%) had EWG. The median pregravid BMI for patients with AWG was significantly higher than in those with EWG (38.6 vs 35.5 kg/m2, p < 0.001). There were no significant differences in the latent phase lengths, total induction times, or frequencies of cesarean delivery and adverse outcomes.

Conclusion: EWG in obese patients undergoing IOL is not associated with increased latent phase lengths, total induction times, or frequencies of cesarean delivery or adverse outcomes. The significantly higher pregravid BMI in the AWG group may have influenced our findings by diminishing the difference in IOL lengths and frequencies of adverse outcomes when compared to the EWG group. Further investigation is necessary to account for this difference in pregravid BMIs and to determine whether EWG is independently associated with higher intrapartum and postpartum adverse outcomes in obese patients undergoing induction of labor.