{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T07:22:40Z","timestamp":1780730560330,"version":"3.54.1"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T00:00:00Z","timestamp":1597881600000},"content-version":"vor","delay-in-days":50,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AJP Rep"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003To assess the impact of gestational weight gain &gt;20 pounds (more than Institute of Medicine [IOM] recommendations) on postpartum infectious morbidity in women with class III obesity.<\/jats:p><jats:p>\n          Methods\u2003This is a retrospective cohort of term, nonanomalous singleton pregnancies with body mass index \u226540 at a single institution from 2013 to 2017. Pregnancies with multiple gestation, late entry to care, and missing weight gain data are excluded. Primary outcome is a composite of postpartum infection (endometritis, urinary tract, respiratory, and wound infection). Secondary outcomes include components of composite, wound complication, readmission, and blood transfusion. Bivariate statistics compared demographics, pregnancy complications, and delivery characteristics of women exceeding IOM guidelines (GT20) with those who did not (LT20). Regression models were used to estimate adjusted odds of outcomes.<\/jats:p><jats:p>\n          Results\u2003Of 374 women, 144 (39%) gained GT20 and 230 (62%) gained LT20. Primiparous, nonsmokers more likely gained GT20 (p\u2009&lt;\u20090.05). No significant difference in other demographics. Among women who gained GT20, 10.4% had postpartum infectious morbidity compared with 3.0% in LT20 (p\u2009&lt;\u20090.01). Wound infection is more common in the GT20 group (7.6 vs. 2%, p\u2009=\u20090.02). After adjustment, women who gained GT20 had threefold higher odds of postpartum infectious morbidity (adjusted odds ratio: 3.17, 95% confidence interval: 1.17, 8.60).<\/jats:p><jats:p>\n          Conclusion\u2003Women with class III obesity who gain more than the IOM recommends are at increased risk for postpartum infectious morbidity.<\/jats:p>","DOI":"10.1055\/s-0040-1715165","type":"journal-article","created":{"date-parts":[[2020,8,21]],"date-time":"2020-08-21T00:48:27Z","timestamp":1597970907000},"page":"e213-e216","source":"Crossref","is-referenced-by-count":7,"title":["Impact of Excess Weight Gain on Risk of Postpartum Infection in Class III Obesity"],"prefix":"10.1055","volume":"10","author":[{"given":"Courtney J.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4698-9283","authenticated-orcid":false,"given":"LaMani","family":"Adkins","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Tucker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haywood","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of South Florida, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Siegel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Dotter-Katz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,8,20]]},"reference":[{"issue":"288","key":"ref2","first-page":"1","article-title":"Prevalence of obesity among adults and youth: United States, 2015-2016","author":"C M Hales","year":"2017","journal-title":"NCHS Data Brief"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1097\/01.AOG.0000425668.87506.4c","article-title":"ACOG committee opinion no. 548: weight gain during pregnancy","volume":"121","year":"2013","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/S1701-2163(15)30994-4","article-title":"The impact of increasing 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of exercise interventions in the prevention of excessive gestational weight gain and postpartum weight retention: a systematic review and meta-analysis","volume":"52","author":"S M Ruchat","year":"2018","journal-title":"Br J Sports Med"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s13679-018-0312-0","article-title":"Prevention of excessive gestational weight gain and postpartum weight retention","volume":"7","author":"N A Nicodemus Jr","year":"2018","journal-title":"Curr Obes Rep"},{"issue":"03","key":"ref12","first-page":"239","article-title":"The institute of medicine guidelines for gestational weight gain after a diagnosis of gestational diabetes and pregnancy outcomes","volume":"32","author":"L M Harper","year":"2015","journal-title":"Am J Perinatol"},{"issue":"17","key":"ref13","doi-asserted-by":"crossref","first-page":"1702","DOI":"10.1001\/jama.2019.3820","article-title":"Association of gestational weight gain with adverse maternal 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