Gökçenur KARAKELLEOĞLU, Elif Ceren Nur KIRIMLI YANIK, Özge KIZILKALE YILDIRIM, Gaye ARSLAN, Cihan KARADAĞ
Zeynep Kamil Medical Journal - 2026;57(2):102-107
Objective: 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. Material and 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 DeltaBMI was calculated as end-of-pregnancy minus baseline BMI. The primary outcome was delivery at >=41 versus <41 weeks. Analyses included chi2, 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). DeltaBMI 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). Conclusion: Excessive GWG was linked to >=41-week delivery in unadjusted but not adjusted analyses, whereas higher DeltaBMI remained associated. Findings underscore the complex role of weight dynamics in late-term pregnancy and support incorporating structured GWG counseling into antenatal care.
