{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T23:43:47Z","timestamp":1782776627625,"version":"3.54.5"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>To compare perinatal outcomes in pregnancies with prepregnancy body mass index (BMI) \u2265 50\u2009kg\/m2 across prespecified gestational weight-gain categories, and to describe maternal characteristics more frequently observed among individuals with preterm delivery.<\/jats:p>\n                  <jats:p>Retrospective cohort study of singleton pregnancies (June 2002\u2013April 2020) at a tertiary academic institution comparing maternal and neonatal outcomes across four prespecified gestational weight-gain categories using unadjusted group-based analyses: weight loss\/no gain, 0.45 to 4.5\u2009kg (1\u201310 lb.), 5.0\u20139.1\u2009kg (11\u201320 lb.), and &gt;9.1\u2009kg (&gt;20 lb.). Statistical comparisons used Kruskal\u2013Wallis H, Mann\u2013Whitney U, Welch ANOVA, and chi-square tests (\u03b1\u2009=\u20090.05), with Holm's correction applied for multiple comparisons.<\/jats:p>\n                  <jats:p>Of 525 identified pregnancies, 483 met inclusion criteria. Groups 1 to 4 included 89, 113, 93, and 188 pregnancies, respectively. The cohort was predominantly parous (73.7%) and non-Hispanic Black (65.1%), with high rates of chronic hypertension (43.5%) and preexisting diabetes (10.1%). Preterm delivery occurred in 14.9% of individuals. Compared with term deliveries, those delivering preterm were older (30 years vs. 28 years; p\u2009=\u20090.01), had higher prepregnancy BMI (55.4 vs. 54.1\u2009kg\/m2; p\u2009=\u20090.026), and were more likely to have chronic hypertension and preeclampsia (both p\u2009&lt;\u20090.01). Fetal growth restriction (FGR) was more frequent in the weight loss\/no-gain group (p\u2009=\u20090.02), and infant birth weight increased linearly with greater gestational weight gain (p\u2009&lt;\u20090.01). No consistent trend in perinatal complications was observed across weight-change categories.<\/jats:p>\n                  <jats:p>In pregnancies with BMI \u2265 50\u2009kg\/m2, perinatal outcomes did not differ consistently across weight-gain categories. Birth weight increased linearly with greater weight gain, while FGR occurred more frequently with weight loss\/no gain. Preterm birth was more frequent among older individuals with chronic hypertension, preeclampsia, and higher prepregnancy BMI; however, independent contributions remain undetermined from unadjusted comparisons. The relationship between gestational weight loss and FGR warrants prospective confirmation.<\/jats:p>","DOI":"10.1055\/a-2890-2010","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T22:58:31Z","timestamp":1781564311000},"source":"Crossref","is-referenced-by-count":0,"title":["Gestational Weight Gain and Perinatal Outcomes in Pregnancies with Prepregnancy BMI =\u00a050\u00a0kg\/m\u00b2"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4812-1664","authenticated-orcid":false,"given":"Oluyemi A.","family":"Aderibigbe","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine \/ Case Western Reserve University, Ohio, United States","place":["Cleveland"],"department":["Department of Reproductive Biology, Division of Maternal-Fetal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly S.","family":"Gibson","sequence":"additional","affiliation":[{"name":"MetroHealth\/Case Western Reserve University, Ohio, United States","place":["Cleveland"],"department":["Department of Reproductive Biology, Division of Maternal-Fetal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"w822","DOI":"10.1377\/hlthaff.28.5.w822","article-title":"Annual medical spending attributable to obesity: payer-and service-specific estimates","volume":"28","author":"E A Finkelstein","year":"2009","journal-title":"Health Aff (Millwood)"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"e128","DOI":"10.1097\/AOG.0000000000004395","article-title":"Obesity in pregnancy: ACOG practice bulletin, number 230","volume":"137","author":"American College of Obstetricians and Gynecologists' Committee on Practice Bulletins-Obstetrics","year":"2021","journal-title":"Obstet 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