According to a study published by JAMA, weight gain during pregnancy (gestational weight gain) that was above or below the guideline recommendations was linked with a higher risk of adverse maternal and infant outcomes, compared with weight gain within recommended levels.
Body mass index (BMI) and weight gain during pregnancy are increasing across the globe. The Institute of Medicine (IOM) provided specific recommendations regarding the ideal weight gain during pregnancy in 2009.
A total weight gain for
- underweight women (BMI less than 18.5) was recommended as 27.6-39.7 lbs
- normal weight woman (BMI is between 18.5 and 24.9) a range of 25.4-35.3 lbs
- overweight women (BMI between 25 and 29.9), a range of 15.4-24.3 lbs
- obese women (BMI is 30 or greater) of 11-19.8 lbs
However, the association between gestational weight gain consistent with the IOM guidelines and pregnancy outcomes is not clear.
Rebecca F. Goldstein, M.B.B.S., F.R.A.C.P., Helena J. Teede, M.B.B.S., F.R.A.C.P., Ph.D., of Monash University, Victoria, Australia, and their colleagues conducted a systematic review and meta-analysis of 23 studies of 1,309,136 women to estimate associations of weight gain during pregnancy, above or below the IOM guidelines, and the corresponding maternal and infant outcomes.
The researchers found that 47% of pregnancies had gestational weight gain greater than the IOM recommendations, while 23% had weight gain less than the recommendations. Gestational weight gain below the recommendations was connected with lower risk of large for gestational age (LGA), higher risk of small for gestational age (SGA), preterm birth and macrosomia-excessive birth weight in the newborn. Gestational weight gain above the recommendations was connected with a lower risk of SGA, higher risk of LGA, preterm birth, macrosomia, and cesarean delivery.
The article noted several limitations of the study such as lack of studies from developing countries, as non-English-language articles were excluded.
Achievement of ideal BMI prior to conception and prevention of excess gestational weight gain was prioritized by the World Health Organization. The authors wrote that lifestyle interventions in pregnancy can assist women to attain the suggested gestational weight gain.