Association of Gestational Weight Gain With Maternal and Infant Outcomes

Abstract

Quiz Ref ID Excessive and insufficient gestational weight gain have been associated with adverse pregnancy outcomes, including small for gestational age (SGA), large for gestational age (LGA), macrosomia, cesarean delivery, gestational diabetes mellitus (GDM), preeclampsia, postpartum weight retention, and offspring obesity.^1-4 The Institute of Medicine (IOM; now known as the National Academy of Medicine) recommendations regarding gestational weight gain were developed in 1990 to guide clinical practice.⁵ These aimed to reduce the incidence of low-birth-weight babies and were based on a 1980 National Natality Survey of a largely white population. The updated IOM guidelines in 2009⁶ incorporated World Health Organization (WHO) categories of maternal body mass index (BMI; calculated as weight in kilograms divided by height in meters squared; BMI for underweight, 7 and recommended less gestational weight gain for obese women (Table 1). The 2009 guidelines identified maternal and infant relationships with gestational weight gain but were based on lower general population BMI with limited ethnic diversity. The 2009 IOM guidelines are endorsed by the American College of Obstetricians and Gynecologists, although they are not universally implemented.⁸