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Association of Gestational Weight Gain With Preterm Birth Among Women of Normal Pre-pregnancy Body Mass Index: A

Mounika Itha1, Bhabani Pegu1, Battini VijayaLakshmi1

  • 1Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND.

Cureus
|April 10, 2026
PubMed

Insights

Gestational weight gain (GWG) extremes were not linked to preterm birth (PTB) in normal BMI women. Maternal education improved outcomes, while prior C-sections increased PTB risk. Monitoring GWG and health literacy are key.

Area of Science:

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

Background:

  • Preterm birth (PTB) before 37 weeks is a leading cause of neonatal morbidity and mortality.
  • Gestational weight gain (GWG) is a known factor influencing PTB risk, with both insufficient and excessive gain associated with adverse pregnancy outcomes.

Purpose of the Study:

  • To investigate the association between gestational weight gain (GWG) and preterm birth (PTB) specifically in women with a normal pre-pregnancy body mass index (BMI).
  • To identify factors that may modify the relationship between GWG and PTB in this population.

Main Methods:

  • A matched case-control study involving 90 women with spontaneous PTB (28-36 weeks) and 360 term controls.
  • Participants were matched for age and parity; GWG was categorized using Institute of Medicine (IOM) guidelines.
  • Conditional logistic regression was employed to analyze the association between GWG and PTB, controlling for potential confounders.

Main Results:

  • Mean GWG was lower in PTB cases compared to controls, but this difference was influenced by earlier delivery in cases.
  • After adjusting for gestational age, GWG itself was not found to be an independent predictor of PTB.
  • Higher maternal education demonstrated a protective effect (OR: 0.41), while a history of caesarean delivery significantly increased PTB risk (OR: 5.23).

Conclusions:

  • In women with normal BMI, extreme ranges of gestational weight gain (GWG) are not independently associated with preterm birth (PTB).
  • Maternal education emerged as a protective factor against PTB, whereas previous caesarean sections were identified as a risk factor.
  • Recommendations include continued monitoring of GWG and enhancing maternal health literacy to potentially mitigate PTB incidence.
Abstract

Keywords:
dietary habitsgestational weight gainnormal body mass indexpregnancy outcomespreterm birth

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