Pregnancy weight gain: still controversial.

During the 20th century, recommendations for maternal weight gain in pregnancy were controversial, ranging from rigid restriction to encouragement of ample gain. In 1990, the Institute of Medicine (IOM) recommended weight-gain ranges with the primary goal of improving infant birth weight. These guidelines were widely adopted but not universally accepted. Critics have argued that the IOM's recommendations are unlikely to improve perinatal outcomes and may actually increase the risk of negative consequences to both infants and mothers. We systematically reviewed studies that examined fetal and maternal outcomes according to the IOM's weight-gain recommendations in women with a normal prepregnancy weight. These studies showed that pregnancy weight gain within the IOM's recommended ranges is associated with the best outcome for both mothers and infants. However, weight gain in most pregnant women is not within the IOM's ranges. All of the studies reviewed were observational and there is a compelling need to conduct experimental studies to examine interventional strategies to improve maternal weight gain with the objective of optimizing health outcomes.

[1]  H. Hoffman,et al.  Prenatal Weight Gain, Term Birth Weight, and Fetal Growth Retardation Among High-Risk Multiparous Black and White Women , 1993, Obstetrics and gynecology.

[2]  Prenatal Weight Gain Patterns and Spontaneous Preterm Birth Among Nonobese Black and White Women , 1995, Obstetrics and gynecology.

[3]  L. Caulfield,et al.  Influence of Maternal Anthropometric Status and Birth Weight on the Risk of Cesarean Delivery , 1995, Obstetrics and gynecology.

[4]  J. Himes,et al.  The effects of cigarette smoking and gestational weight change on birth outcomes in obese and normal-weight women. , 1997, American journal of public health.

[5]  M. Cogswell,et al.  Gestational weight gain among average-weight and overweight women--what is excessive? , 1995, American journal of obstetrics and gynecology.

[6]  B. Luke,et al.  Point of diminishing returns: when does gestational weight gain cease benefiting birthweight and begin adding to maternal obesity? , 1996, The Journal of maternal-fetal medicine.

[7]  B. Frentzen,et al.  Excessive maternal weight and pregnancy outcome. , 1992, American journal of obstetrics and gynecology.

[8]  M. Hediger,et al.  Gestational Weight Gain, Pregnancy Outcome, and Postpartum Weight Retention , 1995, Obstetrics and gynecology.

[9]  B. Abrams.  Weight Gain and Energy Intake during Pregnancy , 1994, Clinical obstetrics and gynecology.

[10]  K. G. Koski,et al.  Timing of weight gain during pregnancy: promoting fetal growth and minimizing maternal weight retention. , 1996, International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity.

[11]  A. Stanton,et al.  IS OVERHEATING A FACTOR IN SOME UNEXPECTED INFANT DEATHS? , 1980, The Lancet.

[12]  S. Selvin,et al.  The pattern of maternal weight gain in women with good pregnancy outcomes. , 1997, American journal of public health.

[13]  J. W. Johnson,et al.  A critique of the new recommendations for weight gain in pregnancy. , 1996, American journal of obstetrics and gynecology.

[14]  J. Parker,et al.  Maternal Weight Gain in Women With Good Pregnancy Outcome , 1990, Obstetrics and gynecology.

[15]  G. Thurnau,et al.  The Preterm Prediction Study: association of cesarean delivery with increases in maternal weight and body mass index. , 1997, American journal of obstetrics and gynecology.

[16]  M. Hediger,et al.  Patterns of Weight Gain in Adolescent Pregnancy: Effects on Birth Weight and Preterm Delivery , 1989, Obstetrics and gynecology.

[17]  S. Taffel,et al.  Pregnancy-related weight gain and retention: implications of the 1990 Institute of Medicine guidelines. , 1993, American journal of public health.

[18]  J. Groff,et al.  Weight gain associated with prenatal smoking cessation in white, non-Hispanic women. , 1996, American journal of obstetrics and gynecology.

[19]  J. Parker,et al.  Differences in postpartum weight retention between black and white mothers. , 1993, Obstetrics and gynecology.

[20]  C. Naylor,et al.  Eating for two: are guidelines for weight gain during pregnancy too liberal? , 1998, The Lancet.

[21]  C. Stevens-Simon,et al.  Determinants of weight gain in pregnant adolescents. , 1991, Journal of the American Dietetic Association.

[22]  C. Hobel,et al.  Predictors of poor maternal weight gain from baseline anthropometric, psychosocial, and demographic information in a Hispanic population. , 1997, Journal of the American Dietetic Association.

[23]  C. Hobel,et al.  Institute of Medicine Maternal Weight Gain Recommendations and Pregnancy Outcome in a Predominantly Hispanic Population , 1994, Obstetrics and gynecology.

[24]  J. Parker,et al.  Prenatal Weight Gain Advice: An Examination of the Recent Prenatal Weight Gain Recommendations of the Institute of Medicine , 1992, Obstetrics and gynecology.

[25]  S. H. Page.  MATERNAL NUTRITION AND THE COURSE OF PREGNANCY , 1971 .

[26]  M. Thompson,et al.  The usefulness of weight gain in predicting pregnancy complications. , 1993, Journal of tropical pediatrics.

[27]  H. Hoffman,et al.  Prenatal Weight Gain Patterns and Birth Weight Among Nonobese Black and White Women , 1996, Obstetrics and gynecology.

[28]  B. Abrams,et al.  A CRITICAL REVIEW OF THE RELATIONSHIP BETWEEN GESTATIONAL WEIGHT GAIN AND PRETERM DELIVERY , 1997, Obstetrics and gynecology.

[29]  L. Caulfield,et al.  Determinants of Gestational Weight Gain Outside the Recommended Ranges Among Black and White Women , 1996, Obstetrics and gynecology.

[30]  J. Green,et al.  Routine weighing in pregnancy. , 1992, BMJ.

[31]  H. Hoffman,et al.  Relationship of Psychosocial Status to Low Prenatal Weight Gain Among Nonobese Black and White Women Delivering at Term , 1995, Obstetrics and gynecology.

[32]  S. Selvin,et al.  Maternal Weight Gain Pattern and Birth Weight , 1995, Obstetrics and gynecology.