TABLE 9Gestational Weight Gain and Shoulder Dystocia

Author, Date
Country, Setting
Sample Size
Baseline BMI
Quality
Pregravid Weight (How Measured)
Total Weight Gain (How Measured)
Definition of GroupsResultsConfounders and Effect Modifiers Included in Analysis
Ekblad and Grenman, 199268

Finland, hospital

357

Normal weight only

Poor
Pregravid weight:
Data from records, unclear if self reported

Total weight gain:
Last clinically measured weight prior to delivery
G1: weight gain ≤ 5 kg
G2: weight gain ≥ 20 kg
G3: reference (normal prepregnancy weight and normal weight gain [undefined])
Shoulder dystocia%
G1: 3
G2: 2
G3: 0.6
NA
Geary et al., 199580

Ireland, hospital

363

All weights/BMI

Poor
Pregravid weight:
First prenatal visit

Total weight gain:
Not described
Weight gain < 12 kg and ≥ 12 kg for cases shoulder dystocia and controls

G1: Cases with shoulder dystocia
G2: Controls
Maternal weight gain < 12 kg

G1: 59.1%
G2: 74.1%
OR 2.0 (1.6–2.2)
Parity
Previous birth ≥ 4,000 g
Kabiru and Raynor, 200451

USA, hospital

5,131

All weights/BMI

Poor
Pregravid weight:
First prenatal visit

Total weight gain:
Weight at admission for birth
G1: normal BMI, no change in BMI between first prenatal visit and delivery
G2: normal BMI, 1 category increase in BMI between first prenatal visit and delivery
G3: normal BMI, > 1 category increase in BMI between first prenatal visit and delivery
G4: overweight BMI, no change in BMI between first prenatal visit and delivery
G5: overweight BMI, 1 category increase in BMI between first prenatal visit and delivery
G6: overweight BMI, > 1 category increase in BMI between first prenatal visit and delivery
Shoulder dystocia%
G1: 0.5
G2: 1.4
G3: 1.1
P = 0.278 for associations within normal BMI categories

G4: 1.0
G5: 1.8
G6: 1.9
P = 0.357 for associations within overweight BMI categories
NA

BMI, body mass index; g, gram; G, group; kg, kilogram; N, number; OR, odds ratio.

From: E, Results from the Evidence-Based Report on Outcomes of Maternal Weight Gain

Cover of Weight Gain During Pregnancy
Weight Gain During Pregnancy: Reexamining the Guidelines.
Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines; Rasmussen KM, Yaktine AL, editors.
Washington (DC): National Academies Press (US); 2009.
Copyright © 2009, National Academy of Sciences.

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