Should Recommended Gestational Weight Gain Be Less in Obese Women?

(HealthDay News) — For some obese women, gestational weight gain below that recommended in the current guidelines may be advised to reduce the risk for certain adverse pregnancy outcomes, according to research published in Obesity Reviews.

Mufiza Zia Kapadia, MBBS, PhD, of McMaster University in Hamilton, Canada, and colleagues conducted a systematic review of the literature to assess the risk of adverse pregnancy outcomes associated with gestational weight gain below the level recommended in the 2009 Institute of Medicine (IOM) guidelines regarding obese women. The researchers performed a meta-analysis of data from 18 cohort studies.

The researchers found that gestational weight gain less than the amount recommended for obese women in the guidelines was associated with higher risk for preterm birth (adjusted OR=1.46) and small for gestational age (SGA) (adjusted OR=1.24) and lower risk for large for gestational age (LGA) (adjusted OR=0.77), compared with gestational weight gain within the guidelines. 

Gestational weight gain less than the recommended amount for obese women also was associated with lower risk for certain adverse pregnancy outcomes, including macrosomia (adjusted OR=0.64), gestational hypertension (adjusted OR=0.70) preeclampsia (adjusted OR=0.90) and cesarean birth (adjusted OR=0.87).

“In summary, our systematic review indicates that obese pregnant women, who gained below the 5 to 9 kg recommended by the IOM guideline had increased risks for [preterm birth] (<37 weeks) and SGA (<10th percentile), but decreased risks for LGA (>90th percentile), macrosomia, gestational hypertension, preeclampsia, and cesarean birth,” the researchers wrote.


  1. Kapadia MZ et al. Obes Rev. 2015;doi:10.1111/obr.12238.