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Is gestational weight gain associated with timing of delivery?
Gökçenur Karakelleoğlu1, Elif Ceren Nur Kırımlı Yanık1, Özge Kızılkale Yıldırım2, Gaye Arslan1, Cihan Karadağ31Department of Obstetrics and Gynecology, Okan University Hospital, Istanbul, Turkey2Department of Obstetrics and Gynecology, Private Practice, Istanbul, Turkey
3Department of Obstetrics and Gynecology, Medicana Kadıköy Hospital, Istanbul, Turkey
INTRODUCTION: To evaluate whether excessive gestational weight gain (GWG) and change in body mass index (BMI) are associated with delivery timing among women delivering at term (≥37 weeks), independent of pre-pregnancy BMI.
METHODS: We conducted a retrospective single-center cohort study including 625 singleton pregnancies delivered between April 2022 and April 2025 at Istanbul Okan University Hospital. Pregnancies with major fetal anomalies, pre-existing maternal disease, induced labors, elective caesareans, or multiple gestations were excluded. GWG was classified according to 2009 Institute of Medicine criteria, and ΔBMI was calculated as end-of-pregnancy minus baseline BMI. The primary outcome was delivery at ≥41 versus <41 weeks. Analyses included χ2, t-test/Mann–Whitney U, ANOVA, and multivariable logistic regression adjusting for maternal age, parity, pre-pregnancy BMI, smoking, education, and fetal sex.
RESULTS: Mean maternal age was 28.8±5.3 years; 17.4% delivered at ≥41 weeks. GWG was above recommendations in 40.2%, within recommendations in 36.0%, and below recommendations in 23.8%. In crude analyses, ≥41-week delivery was more frequent among women above versus within IOM recommendations (21.5% vs. 14.7%, p=0.036). ΔBMI was higher in the ≥41-week group (5.83±1.81 vs. 4.99±1.79 kg/m2; p<0.001). In adjusted models, GWG categories were not independently associated with ≥41 weeks. Compared with normal BMI, underweight (OR 0.18, 95% CI 0.05–0.66) and overweight (OR 0.35, 95% CI 0.16–0.76) women had lower odds. Smoking (OR 2.25, 95% CI 1.12–4.53) increased, while high-school education (vs university) decreased odds (OR 0.18, 95% CI 0.08–0.42).
DISCUSSION AND CONCLUSION: Excessive GWG was linked to ≥41-week delivery in unadjusted but not adjusted analyses, whereas higher ΔBMI remained associated. Findings underscore the complex role of weight dynamics in late-term pregnancy and support incorporating structured GWG counseling into antenatal care.
Keywords: Delivery timing, gestational weight gain, IOM guidelines, maternal body mass index, prolonged pregnancy.
Manuscript Language: English
