Weight Gain during Pregnancy: Importance for Maternal and Child Health

Gestational weight gain is a strong predictor of short- and long-term health outcomes for both childbearing women and their offspring. Epidemiologic studies have found that higher maternal gestational weight gains are associated with abnormalities in maternal prenatal glycemia, hypertensive disorders of pregnancy and delivery complications, along with an increased risk of postpartum weight retention, incident obesity and adverse cardiometabolic sequelae in mothers by midlife. Additionally, observational data have linked greater gestational weight gains to increased fetal growth and later childhood obesity. Associations of gestational weight gain with preterm birth and infant mortality may be U-shaped, such that the risks are increased with both low and high gains. In an attempt to optimize both maternal and child outcomes, the Institute of Medicine revised gestational weight gain guidelines in 2009, recommending smaller gains for women with higher prepregnancy body mass indices, particularly for women entering pregnancy with a body mass index of at least 30. However, it is as of yet unclear if these new recommendations will lead to improvements in the proportions of women gaining recommended amounts, and in maternal and child health. As fewer than one third of mothers currently gain within the ranges recommended by the Institute of Medicine, interventions to help mothers achieve healthy gestational weight gains are of critical public health importance.