Pregnancy outcomes with weight gain above or below the 2009 institute of medicine guidelines

摘要

To the Editor:In Johnson and colleagues' excellent study, women who gained more weight than recommended were at 50% increased risk for cesarean delivery and gestational hypertension and preeclampsia combined (although the proportion of indicated preterm births remained unchanged: 2.9% compared with 2.7%, P=.671), and they were at a twofold greater risk for having large-for-gesta-tional-age (LGA) neonates. However, they also had a 37% and 16% lower risk of giving birth to small-for-gestational-age (SGA) and preterm (7.5% compared with 9.0%, P= .028) neonates, respectively. The authors estimate that if all pregnant women in the United States had actually gained within or under the guidelines (not only within, as incorrectly noted), there would be 342,000, 273,000, and 201,000 fewer cases of pregnancy hypertensive disorders, cesarean deliveries, and LGA neonates annually, respectively. However, it should be mentioned that there would also be 46,000 and 197,000 more preterm and SGA neonates, respectively. Considering that the former results are obtained from a cohort of women