Postprint version. Published in American Journal of Obstetrics and Gynecology, Volume 206, Issue 1, January 1, 2012, pages S364-S365.
OBJECTIVE: We sought to estimate the costs and outcomes associated with keeping gestational weight gain within the 2009 Institute of Medicine (IOM) recommendations.
STUDY DESIGN: A decision analytic model was built using TreeAge software that compared the cost of gestational weight gain categorized by staying within versus exceeding the IOM guidelines in normal weight and obese women. We assumed the obesity prevalence from the most recent data in 2008 and applied to the estimated 4,000,000 million births per year. Outcomes included: gestational diabetes, preeclampsia, macrosomia (>4500g), small-forgestational age, postterm delivery, cesarean delivery, postpartum weight retention, and child obesity.
RESULTS: Normal weight women who gained within the IOM recommendations incurred $2,502 less costs than normal weight women who exceeded the IOM recommendations. Obese women who gained within the IOM recommendations incurred $6,501 less costs than obese women who exceeded the IOM recommendations. With lower costs and better outcomes adhering to IOM guidelines for gestational weight gain is a dominant strategy. When applied to the U.S. population, gaining within IOM guidelines could lead to $12.7 billion dollars of savings. In addition, staying within the IOM guidelines would result in 76,400 fewer cesarean deliveries for normal weight women and 408,000 for obese women (see table).
CONCLUSION: From a societal standpoint, there is economic benefit to staying within the IOM guidelines for gestational weight gain. With such an enormous potential impact on economic and clinical outcomes, further research into accomplishing these guidelines should be widespread.