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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 2

Category: Obstetric Quality and Safety

Poster Session 2

(514) Severity of excess gestational weight gain and dyadic outcomes in normal BMI pregnancies

Wednesday, February 11, 2026
3:30 PM - 5:00 PM  
Objective:
To evaluate the association between excess gestational weight gain (EGWG) and maternal-newborn dyadic outcomes using the desirability of outcome ranking (DOOR) methodology among patients with normal prepregnancy body mass index (BMI).

Study Design:
This retrospective cross-sectional study included all deliveries eligible for the Joint Commission’s PC-06 quality metric (term newborns without preexisting conditions) at seven hospitals within a large New York health system (2019–2024). Only each patient’s first delivery was analyzed. Among patients with normal BMI, gestational weight gain was categorized as appropriate (≤35 lb per 2009 Institute of Medicine guidelines) or excess ( >35 lb), and further classified as mild (36–44 lb), moderate (45–54 lb), or severe (≥55 lb). DOOR methodology grouped outcomes by delivery mode and presence of maternal or neonatal complications: (1) uncomplicated vaginal delivery, (2) uncomplicated cesarean, (3) vaginal delivery with complications, and (4) cesarean with complications. Multinomial logistic regression assessed the association between EGWG and DOOR category, adjusting for race and ethnicity, insurance, language, multiparity, and the obstetric comorbidity index (OB-CMI).

Results:
Of 43,502 patients, dyadic outcomes by EGWG category are shown in the Figure; regression results appear in the Table. Compared to those without EGWG, patients with mild, moderate, and severe EGWG had progressively higher adjusted odds of cesarean with complications (aORs 1.17, 1.37, 1.64), and uncomplicated cesarean (aORs 1.27, 1.49, 1.70). Severe EGWG was also associated with higher odds of vaginal delivery with complications (aOR 1.64; 95% CI, 1.27–2.11).

Conclusion:
In pregnancies with normal BMI, EGWG is an independent predictor of worse maternal-newborn outcomes. A clear dose-response pattern was observed, even after adjustment for comorbidities and social determinants.