Background: Maternal undernutrition and inadequate gestational weight gain (GWG) remain significant public health concerns in India, contributing to adverse maternal and neonatal outcomes. Despite the critical importance of appropriate GWG for healthy pregnancy outcomes, comprehensive synthesized evidence specific to Indian populations is limited. Objectives: This systematic review and meta-analysis protocol aims to: (1) estimate the pooled mean gestational weight gain among pregnant women in India; (2) determine the prevalence of maternal undernutrition (BMI <18.5 kg/m²); and (3) quantify proportions of pregnant women achieving inadequate, adequate, or excessive GWG within BMI categories based on Institute of Medicine (IOM) Methods: We will systematically search PubMed, Embase, Scopus, Web of Science, and IndMED for observational studies published from 2000 onwards. Two independent reviewers will screen titles, abstracts, and full texts, extract data using standardized forms, and assess study quality using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist and Newcastle-Ottawa Scale (NOS). Random-effects meta-analyses will be conducted to pool mean GWG, prevalence of undernutrition, and GWG adequacy proportions. Heterogeneity will be assessed using I² statistics, and subgroup analyses will explore variations by geographic region, urban/rural setting, study quality, and publication year. Publication bias will be evaluated using funnel plots and Egger’s test. The certainty of evidence will be assessed using the GRADE framework. Discussion: This review will provide robust, pooled estimates of GWG patterns and maternal undernutrition prevalence in India, informing evidence-based maternal nutrition interventions and policy development. The findings will highlight gaps in current knowledge and identify priority areas for future research. Systematic Review Registration: OSF. Keywords: gestational weight gain, maternal undernutrition, body mass index, pregnancy, India, systematic review, meta-analysis, protocol
Manna et al. (Wed,) studied this question.