Overweight and obesity in pregnancy - a retrospective cohort study in Germany.

Overweight and obesity are common among women of reproductive age. 43.8% of women in Germany and 50% of women in the US entering their pregnancy have a body mass index (BMI)≥25. Studies indicate that gestational overweight is associated with maternal and neonatal complications.2034 women from 2015 until 2018 were included. Trends in BMI, gestational weight gain, pregnancy outcome, complications, neonatal weight, and outcome were analyzed. Gestational weight gain was evaluated according to the Institute of Medicine (IOM) guidelines. 34% of the population were overweight with a BMI≥25. The overall weight gain was similar across BMI groups (median 11.0-14.0 kg). 44.1% gained more than recommended. These women were at higher risk of labor induction (33.1% vs. 27.0%, p=0.003), unplanned cesarean section (18.6% vs. 13.6%, p=0.004), lower incidence of spontaneous vaginal birth (54.5% vs. 59.9%, p=0.009), and higher neonatal birth weight (>90^th percentile, 14.5% vs. 5.7%, p<0.001). Gestational diabetes was linked to a lower gestational weight gain (odds ratio 0.92, confidence interval 0.90-0.95, p<0.001).One third of the analyzed population was already overweight or obese at the beginning of the pregnancy. In 44.1% of cases, weight gain during pregnancy exceeded the recommended amount. This was associated with complications in pregnancy and labor as well as higher neonatal birth weight. This study highlights the importance of prenatal counseling and intervention on BMI and weight gain.