Weight gain: what the guidelines say and what they predict
Associations, in both directions.
The 2009 National Academies ranges, still used in US care, are 28 to 40 pounds for underweight women, 25 to 35 for normal weight, 15 to 25 for overweight and 11 to 20 for obese.
In a meta-analysis of 23 studies and 1,309,136 women, 23% gained less than recommended and 47% gained more.
| Outcome | Gaining below the range | Gaining above the range |
|---|---|---|
| Small-for-gestational-age baby | 5 percentage points more | 3 points fewer |
| Large-for-gestational-age baby | 2 points fewer | 4 points more |
| Preterm birth | 5 points more | 2 points fewer |
| Cesarean delivery | No significant difference | 4 points more |
The part usually left outNearly half of women gain more than the range, and a quarter gain less, which means these categories describe most pregnancies rather than a minority. And these are associations, not proof that changing your weight gain changes the outcome. Weight in pregnancy is also one of the topics women most often report being spoken to badly about.
Where this comes from:
169. Rasmussen KM, Yaktine AL, editors. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academies Press; 2009.
170. Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, et al. Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis. JAMA. 2017;317(21):2207-2225.
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