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Child Health USA 2013 An illustrated collection of current and historical data, published annually.

Weight Gain During Pregnancy

Narrative

Gaining too much or too little weight during pregnancy can produce immediate and long-term health risks to a woman and her infant.1 Excessive weight gain may increase the risk of pregnancy complications, cesarean delivery, larger infant birth weight, and postpartum weight retention that may lead to obesity and other related health risks in subsequent pregnancies. Although inadequate weight gain poses little health risk to mothers, it may result in small or growth-restricted infants, which increases the risk for infant mortality and developmental delays.2

Recommendations regarding gestational weight gain vary based on a woman’s pre-pregnancy body mass index—a ratio of weight to height. According to the Institute of Medicine, women of normal weight are recommended to gain between 25 and 35 pounds while those who are underweight should gain slightly more and those who are overweight or obese at the beginning of pregnancy should gain significantly less. Weight gains below these recommended levels may be considered inadequate, while those above may be excessive. Among women in a 30-state reporting area who delivered singleton infants at 37+ weeks’ gestation in 2009–2010, only about 1 in 3 or 31.8 percent gained the recommended amount of weight and nearly half (47.8 percent) gained an excessive amount of weight during pregnancy. About one in five women (20.5 percent) gained an inadequate amount of weight in pregnancy.

Compared to women of other racial and ethnic groups, non-Hispanic Asian women were most likely to gain the recommended amount of weight (39.3 percent) and least likely to gain an excessive amount (33.3 percent). Excessive weight gain exceeded 50 percent among non-Hispanic Native Hawaiian/Other Pacific Islander and non-Hispanic women of multiple races, with rates that were significantly higher than those for non-Hispanic Black, Hispanic and non-Hispanic Asian women. Conversely, about 1 in 4 Hispanic, non-Hispanic Black, and non-Hispanic Asian women had inadequate weight gain. Prenatal care appointments provide an important opportunity to monitor weight gain and receive counseling for dietary and physical activity modifications to meet recommended levels.3

1 Rasmussen KM, Yaktine AL, Institute of Medicine. Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academies Press; 2009.

2 Rasmussen KM, Yaktine AL, Institute of Medicine. Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academies Press; 2009.

3 Rasmussen KM, Yaktine AL, Institute of Medicine. Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academies Press; 2009.

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Graphs

This image is described in the Data section.

weight gain by prepregnancy weight table

This image is described in the Data section.

weight gain by race/ethnicity graph

Data

Recommended Total Gestational Weight Gain (Pounds), by Pre-pregnancy Weight,* Institute of Medicine, 2009
Pre-Pregnancy Weight Inadequate weight gain in pounds Adequate weight gain in pounds Excessive weight gain in pounds
*Underweight is defined as having a Body Mass Index (BMI) of less than 18.5. Normal weight is defined as having a BMI between 18.5 and 24.9. Overweight is defined as having a BMI between 25.0 and 29.9. Obese is defined as having a BMI of 30.0 or more. Recommendations for total weight gain apply to women delivering singleton infants at term (37+ weeks’ gestation).
Source: Adapted from Rasmussen KM, Yaktine AL, Institute of Medicine. Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academies Press; 2009.
Underweight less than 28 28-40 more than 40
Normal Weight less than 25 25-35 more than 35
Overweight less than 15 15-25 more than 25
Obese less than 11 11-20 more than 20
Gestational Weight Gain Adequacy,* by Race/Ethnicity, 2009-2010**
Race/Ethnicity Inadequate Adequate Excessive
*Defined according to Institute of Medicine (IOM) gestational weight gain recommendations for women delivering singleton infants at term (37+ weeks’ gestation).
**Includes data from a total of 30 states and New York City; 25 states contributed all 3 years. Mothers completed surveys between 2 and 9 months postpartum.
Source: Centers for Disease Control and Prevention, Pregnancy Risk Assessment Monitoring System, 2009-2010. Analysis conducted by the Centers for Disease Control and Prevention, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion.
Non-Hispanic White 17.9 32.6 49.5
Non-Hispanic Black 25.0 27.3 47.7
Hispanic 23.9 31.3 44.8
Non-Hispanic American Indian/Alaska Native 22.5 28.4 49.1
Non-Hispanic Asian 27.4 39.3 33.3
Non-Hispanic Native Hawaiian/Other Pacific Islander 16.6 29.2 54.1
Non-Hispanic Multiple Race 21.5 24.9 53.5
Total 20.5 31.8 47.8