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Gestational Weight Gain: Update on Outcomes and Interventions.

Macie L Champion1, Lorie M Harper2

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Current Diabetes Reports
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Excessive gestational weight gain is linked to adverse perinatal outcomes. While lifestyle interventions may reduce weight gain, they haven't improved pregnancy outcomes, necessitating more research.

Keywords:
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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Public Health Nutrition

Background:

  • Gestational weight gain (GWG) is a critical factor influencing perinatal health.
  • Updated Institute of Medicine (IOM) guidelines in 2009 prompted extensive research, especially concerning women with obesity.
  • The ongoing obesity epidemic fuels interest in optimizing GWG for all pregnant individuals.

Purpose of the Study:

  • To review existing evidence on the association between GWG and perinatal outcomes.
  • To specifically examine outcomes related to GWG outside the IOM guidelines.

Main Methods:

  • Systematic review of studies examining GWG and perinatal outcomes.
  • Analysis of randomized controlled trials (RCTs) on lifestyle interventions for GWG.
  • Evaluation of evidence regarding weight gain outside IOM recommendations.

Main Results:

  • GWG is associated with adverse perinatal outcomes, including fetal growth issues, preterm birth, cesarean delivery, gestational diabetes, hypertensive disorders, and infant mortality.
  • Lifestyle interventions can modify GWG but have not consistently improved perinatal outcomes.
  • Weight loss in pregnancy shows potential benefits (reduced macrosomia, cesarean delivery) but carries risks (low birth weight) and is not currently recommended.

Conclusions:

  • Excessive GWG is linked to numerous adverse maternal and fetal outcomes.
  • Pregnancy lifestyle interventions may help manage GWG but lack proven benefits for most adverse pregnancy outcomes.
  • Further research is required before recommending weight loss strategies for women with obesity during pregnancy.