LAUSR

BACKGROUND Women in study areas suffered from the problems of caesarean delivery (CD), low birth weight (LBW), and macrosomia. OBJECTIVE To investigate how gestational weight gain (GWG) influences the effect of the pre-pregnancy body mass index (BMI) on the risks of CD, LBW, and macrosomia in urban and rural areas in a city of Iran. METHODS We used 767 and 612 eligible subjects from the public health care centers in urban and rural areas respectively. RESULTS The risk of CD increased from 74% to 2.62-fold in urban and from 62% to 2.15-fold in rural areas, and the risk of macrosomia increased from 58% to 2.35-fold in urban and from 47% to 96% in rural areas, among obese women compared to normal weight women who gained above median GWG. The risk of LBW increased from 38% to 92% in urban and from 49% to 97% in rural areas among lean women compared to normal weight women who gained below median GWG. CONCLUSION These findings strongly support the need to reform adequate pre-pregnancy weight and GWG against the risks of CD and macrosomia among overweight and obese women, and against the risk of LBW among lean women in both areas.