Pregnant patients with severe or critical coronavirus disease 2019 (COVID-19), but not those with mild or moderate COVID-19, were at increased risk for perinatal complications compared with asymptomatic patients.

OBJECTIVE To evaluate pregnancy outcomes according to 2009 Institute of Medicine (IOM) gestational weight gain guidelines. METHODS This study is a secondary analysis of a preeclampsia prevention trial among nulliparas carrying singletons. Odds ratios and 95% confidence intervals (adjusted for maternal age, race, smoking, and treatment group) were calculated based on total weight gain below or above the IOM guidelines, stratified by prepregnancy body mass index (BMI). The referent group was weight gain within the guidelines. RESULTS Of 8,293 pregnancies, 9.5% had weight gain below, 17.5% within, and 73% above IOM guidelines. With excess weight gain, all BMI categories had an increased risk of hypertensive disorders; normal weight and overweight women also had increased risk of cesarean delivery and infant birth weight at or above the 90th centile but a decreased risk of weight below the10th centile. There were no consistent associations with insufficient weight gain and adverse outcomes. CONCLUSION Excess weight gain was prevalent and associated with an increased risk of hypertensive disorders, cesarean delivery and large for gestational age infants..