Evidence map›Paper›PMID 40796020›Full record

ArticleJournal of gynecology obstetrics and human reproduction2025

Excessive gestational weight gain associated with higher risk of cesarean delivery across body mass index categories in the United States.

Pearl A Mcelfish, Nicola L Hawley, Aaron R Caldwell, James P Selig, Donya Watson, Enrique Gomez-Pomar, Jennifer A Andersen, Shashank Kraleti, Lanita White, Don E Willis and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of gynecology obstetrics and human reproduction, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Pearl A McelfishCollege of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA; Institute for Community Health Innovation, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA. Electronic address: PAMcelfish@uams.edu.
Nicola L HawleyDepartment of Chronic Disease Epidemiology, Yale School of Public Health, 60 College St., New Haven, CT 06510, USA.
Aaron R CaldwellInstitute for Community Health Innovation, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA; Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA.
James P SeligInstitute for Community Health Innovation, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA; Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA.
Donya WatsonCollege of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA; South Arkansas Regional Hospital, 706 W. Grove St., El Dorado, AR 71730, USA.
Enrique Gomez-PomarCollege of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA; Neonatology, St Bernards Regional Medical Center, 225 E. Washington Ave., Jonesboro, AR 72401, USA.
Jennifer A AndersenCollege of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA; Institute for Community Health Innovation, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA.
Shashank KraletiCollege of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA.
Lanita WhiteCommunity Health Centers of Arkansas, 706 W. 4th St., North Little Rock, AR 72114, USA.
Don E WillisCollege of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA; Institute for Community Health Innovation, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA.
Krista LangstonInstitute for Community Health Innovation, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA.
Nirvana ManningCollege of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA.
Jennifer A Callaghan-KoruCollege of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA; Institute for Community Health Innovation, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA.
Austin PorterFay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA; Arkansas Department of Health, 4815 W. Markham St., Little Rock, AR 72205, USA.
Clare C BrownFay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA.

Funding

NHLBI Maternal Morbidity and Mortality (3M) Administrative Coordinating CenterOT2HL158287 · NHLBI · WESTAT, INC. · PI Chanza Baytop · 2020 to 2026
$433.8M
Expanding Translational Research in ArkansasUL1TR003107 · NCATS · UNIV OF ARKANSAS FOR MED SCIS · PI JAMES, LAURA P · 2019 to 2023
$21.6M
Algorithmic fairness in predictive models to eliminate disparities in adverse infant outcomes: A case for raceK01MD018072 · NIMHD · UNIV OF ARKANSAS FOR MED SCIS · PI BROWN, CLARE C · 2022 to 2025
$496k
NCATS NIH HHS UL1 TR003107NHLBI NIH HHS OT2 HL158287NIMHD NIH HHS K01 MD018072
6 · The paper itself

Abstract

objectivesThis research investigated associations between rate of gestational weight gain (GWG; "below recommended rate," "within recommended rate," and "exceeding recommended rate") and increased risk of cesarean delivery for women across a range of body mass index (BMI) categories (underweight, normal, overweight, obesity classes I, II, and III). STUDY

designWe used vital records data from the National Center for Health Statistics to include nulliparous, singleton term births with cephalic presentation (n=7,891,653) to women who gave birth in the United States from 2014 through 2022. We evaluated the association of GWG on mode of birth (cesarean vs. vaginal delivery) using multivariable linear probability (categorical GWG) and generalized additive (continuous GWG) models.

resultsApproximately 26% of births were by cesarean delivery and 65% exceeded the recommended rate of GWG. Risk of cesarean delivery increased as BMI increased, and those in pre-pregnancy BMI above normal categories had higher risk of cesarean delivery. Excessive GWG (EGWG) increased the risk of cesarean delivery for all women, but the effect was more pronounced in those with a higher pre-pregnancy BMI. Among women whose BMI was underweight or normal, GWG had a J-shaped relationship with cesarean delivery risk, while women whose pre-pregnancy BMI was categorized as overweight or obese demonstrated a relatively linear increase in risk with any GWG.

conclusionsFindings provide valuable insights on EGWG and increased risk of cesarean delivery for women across BMI categories. Additional efforts are needed at both the patient and provider level to reduce EGWG and the risk of cesarean delivery.

Indexed as

Body mass indexCesarean deliveryExcessive gestational weight gainGestational weight gainMaternal mortality

Identifiers

PMID40796020
PMCPMC12434902

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.