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Poster Session 2

Category: Medical/Surgical/Diseases/Complications

Poster Session 2

(565) Adverse Pregnancy Outcomes in Patients with Excessive Gestational Weight Gain versus Pre-Pregnancy Obesity

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Lily K. Wiedmer, BS, MS

Medical Student
University of Alabama at Birmingham
Birmingham, Alabama, United States

Coauthor(s)

YY

Yuanfan Ye, PhD

Statistician
Center for Research in Women’s Health, University of Alabama at Birmingham
Birmingham, Alabama, United States
Moti Gulersen, MD, MSc

Assistant Professor
Thomas Jefferson University
PHILADELPHIA, Pennsylvania, United States
Ashley N. Battarbee, MD, MSCR

Associate Professor, Maternal-Fetal Medicine
Center for Research in Women’s Health, University of Alabama at Birmingham
Birmingham, Alabama, United States
Ayodeji A. Sanusi, MD, MPH (he/him/his)

Assistant Professor, Maternal-Fetal Medicine
Center for Research in Women’s Health, University of Alabama at Birmingham
Birmingham, Alabama, United States

Objective:
Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are increasingly used to treat obesity but cannot be continued during pregnancy, putting patients at risk of rapid gestational weight gain. Our objective was to model the tradeoffs of GLP-1 RA by comparing outcomes between individuals with excessive gestational weight gain (GWG) without pre-pregnancy obesity, versus those with pre-pregnancy obesity.

Study Design:
Secondary analysis of a prospective cohort of deliveries at 25 U.S. hospitals (2008-2011). We included pregnant patients with data on pre-pregnancy/first prenatal visit BMI and GWG. Patients with pregestational diabetes or BMI< 18.5 were excluded. The primary outcome was GDM. Baseline characteristics and outcomes were compared between patients with excessive GWG without obesity to those with pre-pregnancy obesity. Log binomial regression estimated associations between excessive GWG without obesity and outcomes. In sensitivity analyses we 1) restricted the cohort to term deliveries and 2) excluded patients with normal BMI.

Results:
Of 24,720 included patients, 13,789 (56%) had excessive GWG without obesity and 10,391 (44%) had pre-pregnancy obesity. Patients with excessive GWG without obesity had mean BMI 24.5 ± 3.0 and GWG 19.2 ± 6.6kg. Patients with pre-pregnancy obesity had mean BMI 35.9 ± 5.6 and GWG 8.9 ± 9.8kg. After adjusting for covariates that differed between groups, excessive GWG without obesity was associated with a lower risk of GDM (4% vs 12%; aRR 0.36, CI 0.32-0.39), hypertensive disorder, cesarean and maternal ICU admission (Fig & Table). Compared with pre-pregnancy obesity, excessive GWG without obesity was also associated with lower risk of congenital malformation, preterm birth, LGA, hypoglycemia, NICU admission and severe morbidity (Fig & Table). Findings were consistent in sensitivity analyses.

Conclusion:
Excessive GWG may be preferable to pre-pregnancy obesity given lower risk of adverse outcomes. Further research is needed to directly assess the pregnancy benefits of preconception GLP-1 RA use for treatment of obesity.