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Weight Gain During Pregnancy: Reexamining the Guidelines (2009)

Chapter: Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain

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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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APPENDIX C
Supplementary Information on Composition and Components of Gestational Weight Gain

Tables C-1 through C-6 summarize literature and data that are referenced and/or support the discussion in Chapter 3, Composition and Components of Gestational Weight Gain: Physiology and Metabolism.

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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STUDIES ON COMPOSITION AND COMPONENTS OF GESTATIONAL GAIN: PHYSIOLOGY AND METABOLISM

TABLE C-1A Maternal Weight Gain in Singleton Pregnancies (by trimester and total weight gain)

Study Description

Population Characteristics

Study Criteria

Weight Gain by Trimester

Total Weight Gain

1st

2nd

3rd

Author, year:

Abrams et al., 1995

Total Study N:

10,418

By ethnicity:

 

 

 

 

Hispanic

0.15 kg/wk

0.54 kg/wk

0.54 kg/wk

 

White

0.19 kg/wk

0.58 kg/wk

0.52 kg/wk

 

Black

0.21 kg/wk

0.52 kg/wk

0.49 kg/wk

 

Asian

0.11 kg/wk

0.56 kg/wk

0.52 kg/wk

 

Country:

USA

Other

0.14 kg/wk

0.56 kg/wk

0.52 kg/wk

 

By BMI:

 

 

 

 

Low BMI

0.15 kg/wk

0.57 kg/wk

0.49 kg/wk

 

Ideal BMI

0.18 kg/wk

0.58 kg/wk

0.53 kg/wk

 

High BMI

0.18 kg/wk

0.51 kg/wk

0.51 kg/wk

 

Obese

0.14 kg/wk

0.41 kg/wk

0.49 kg/wk

 

By fetal size:

 

 

 

 

SGA

0.13 kg/wk

0.48 kg/wk

0.48 kg/wk

 

AGA

0.17 kg/wk

0.56 kg/wk

0.52 kg/wk

 

LGA

0.22 kg/wk

0.62 kg/wk

0.57 kg/wk

 

Author, year:

Abrams and Selvin, 1995

Total Study N:

2,994

 

2.1 kg

7.7 kg

6.6 kg

16.7 kg

Group Description:

White non-obese women

 

 

 

 

 

Country:

USA

 

 

 

 

 

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Author, year:

Abrams et al., 1989

Total Study N:

2,163

Preterm deliveries (n = 118)

 

 

 

11 kg (0.33 kg/wk)

Term deliveries (n = 2,045)

14.5 kg (0.39 kg/wk)

Group Description:

Women at high risk for nutritional problems during pregnancy

Country:

USA

Author, year:

Amador et al., 2008

Total Study N:

220

Obese (n = 110)

 

 

 

7.4 kg

Non-obese (n = 110)

9.4 kg

Country:

Mexico

Author, year:

Bianco et al., 1998*

Total Study N:

11,926

 

 

 

 

Mean:

Morbidly obese (n = 613)

9.1 kg

Non-obese (n = 11,313)

14.2 kg

Group Description:

Women

Country:

USA

Author, year:

Carmichael et al., 1997

Total Study N:

4,218

 

Mean:

Mean:

Mean:

 

Underweight

1.92 kg

0.57 kg/wk

0.48 kg/wk

Group Description:

Women with good pregnancy outcomes

Normal weight

2.19 kg

0.58 kg/wk

0.51 kg/wk

Overweight

2.16 kg

0.51 kg/wk

0.49 kg/wk

Country:

USA

Obese

1.65 kg

0.41 kg/wk

0.47 kg/wk

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Study Description

Population Characteristics

Study Criteria

Weight Gain by Trimester

Total Weight Gain

1st

2nd

3rd

Author, year:

Catalano et al., 1993

Total Study N:

390

Women with GDM (n = 78)

 

 

 

12.6 kg

Controls (n = 312)

 

 

 

15.0 kg

Underweight

 

 

 

 

Country:

USA

GDM (n = 15)

0.24 kg/wk

0.35 kg/wk

0.34 kg/wk

12.2 kg

Control (n = 92)

0.28 kg/wk

0.38 kg/wk

0.39 kg/wk

15.0 kg

Average weight

 

 

 

 

GDM (n = 34)

0.29 kg/wk

0.42 kg/wk

0.39 kg/wk

14.6 kg

Control (n = 172)

0.35 kg/wk

0.40 kg/wk

0.40 kg/wk

15.2 kg

Overweight

 

 

 

 

GDM (n = 29)

0.27 kg/wk

0.32 kg/wk

0.30 kg/wk

10.5 kg

Control (n = 48)

0.28 kg/wk

0.36 kg/wk

0.37 kg/wk

14.1 kg

Author, year:

Cedergren, 2006*

Total Study N:

245,526

BMI < 20

 

 

 

13.5 kg

BMI 20-24.9

13.8 kg

BMI 25-29.9

13.2 kg

BMI 30-34.9

11.1 kg

BMI > 35

8.7 kg

Country:

Sweden

Author, year:

Claesson et al., 2008

Total Study N:

348

Obese (n = 155)

 

 

 

8.7 kg

Controls (n = 193)

11.3 kg

Adjusted:

7.5 kg

9.8 kg

Country:

Sweden

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Author, year:

Gunderson et al., 2001*

Total Study N:

985

Pregravid BMI:

 

 

 

Hispanic:

White:

Black:

Asian:

Underweight (n = 266)

12.1 kg

12.6 kg

13.5 kg

12.1 kg

Group Description:

Healthy women

Normal (n = 595)

12.9 kg

13.2 kg

13.8 kg

11.8 kg

Overweight (n = 71)

13.5 kg

14.7 kg

14.3 kg

13.4 kg

Obese (n = 53)

11.0 kg

10.6 kg

10.9 kg

11.9 kg

Country:

USA

Race/ethnicity:

 

 

 

 

Hispanic (n = 130)

White (n = 532)

Black (n = 100)

Asian (n = 223)

Author, year:

Hediger et al., 1989

Total Study N:

1,790

Total (n = 1,790)

7.29 kg

 

7.46 kg

14.75 kg

 

 

 

Adequate gain (n = 955)

9.12 kg

9.26 kg

18.38 kg

Early inadequate (n = 304)

1.89 kg

8.89 kg

10.78 kg

Group Description:

Adolescents

Late inadequate (n = 387)

8.94 kg

3.27 kg

12.21kg

Country:

USA (Camden, NJ)

Both inadequate (n = 144)

2.18 kg

3.69 kg

5.87 kg

(early gain, 0-24 wks)

(late gain, 24 wks-delivery)

(0-delivery)

Author, year:

Hickey et al., 1995

Total Study N:

1,015

Black women, pregravid BMI:

 

 

 

 

 

 

Group Description:

Non-obese low-income black and white women

Low BMI (n = 255)

2.61 kg

0.49 kg/wk

0.46 kg/wk

Normal BMI (n = 422)

2.54 kg

0.46 kg/wk

0.45 kg/wk

Country:

USA

White women, pregravid BMI:

 

 

 

Low BMI (n = 143)

2.93 kg

0.52 kg/wk

0.42 kg/wk

Normal BMI (n = 195)

1.81 kg

0.52 kg/wk

0.45 kg/wk

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Study Description

Population Characteristics

Study Criteria

Weight Gain by Trimester

Total Weight Gain

1st

2nd

3rd

Author, year:

Johnston et al., 1992

Total Study N:

272

Adolescents (n = 123)

 

 

 

15.4 kg

Adults (n = 149)

14.4 kg

(39.6 wks gestation)

Group Description:

Middle class, upper class

Country:

USA

Author, year:

Kinnunen et al., 2007

Total Study N:

132

Intervention (n = 48)

 

 

 

14.6 kg

Control (n = 56)

14.3 kg

Group Description:

Primiparas

Country:

Finland

Author, year:

Kramer et al., 1992

Total Study N:

9,742

Mean prepregnancy BMI:

 

 

 

14.5 kg

22.1 kg/m2

(0.37 kg/wk)

Group Description:

Mostly Canadian-born, Caucasians

Time of delivery:

 

≥ 37 weeks

14.6 kg

< 37 weeks

12.5 kg

< 34 weeks

9.9 kg

< 32 weeks

9.1 kg

Author, year:

Lawton et al., 1988

Total Study N:

334

Delivered SGA infant (n = 30)

 

 

0.99 kg

12.6 kg

Delivered AGA infant (n = 128)

1.95 kg (gain between 28-32 weeks)

12.8 kg

Group Description: Predominantly white women

Country:

UK

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Author, year:

Loris et al., 1985

Total Study N:

145

Pregravid weight/height:

 

 

 

 

75%-90% ideal weight (n = 25)

16 kg

Group Description:

Teens, aged 13-19 years Delivered at term

91%-110% ideal weight (n = 68)

18 kg

Country:

USA

111%-166% ideal weight (n = 28)

17 kg

Author, year:

Muscati et al., 1996*

Total Study N:

371

Normal weight (90-120% of standard pregravid wt/ht)

0-20 wks:

21-30 wks:

31-term:

 

Group Description:

Healthy, white, nonsmoking women

PPWR < median

3.8 kg

5.3 kg

4.1 kg

13.2 kg

PPWR ≥ median

7.1 kg

6.8 kg

6.2 kg

20.2 kg

Country:

Canada

Underweight (< 90% of standard pregravid wt/ht)

 

 

 

 

PPWR < median

3.8 kg

5.4 kg

4.1 kg

13.3 kg

PPWR ≥ median

7.1 kg

6.4 kg

6.1 kg

19.6 kg

Overweight (> 120% of standard pregravid wt/ht)

 

 

 

 

PPWR < median

1.4 kg

4.5 kg

3.7 kg

9.6 kg

PPWR ≥ median

7.6 kg

6.2 kg

5.3 kg

19.1 kg

Author, year:

Oken et al., 2007*

Total Study N:

1,044

Prepregnancy BMI:

 

 

 

 

< 19.8 (n = 124)

15.7 kg

19.8-26.0 (n = 622)

16.4 kg

26.1-29.0 (n = 134)

15.3 kg

> 29.0 (n = 164)

13.1 kg

Country:

USA

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Study Description

Population Characteristics

Study Criteria

Weight Gain by Trimester

Total Weight Gain

1st

2nd

3rd

Author, year:

Rees et al., 1992

Total Study N:

459

Birth weight:

 

 

 

 

< 3,000 g (n = 88)

 

 

0.50 kg/wk

13.8 kg

Group Description:

Adolescents

3,000-4,000 g (n = 274)

 

 

0.58 kg/wk

16.6 kg

Country:

USA

 

 

 

 

 

Author, year:

Rosso, 1985

Total Study N:

262

Prepregnancy weight:

 

 

 

 

Group Description:

Mostly black (51%) and Hispanic (41%) women

Underweight, < 89% standard weight (n = 62)

 

 

 

12 kg

Country:

USA

Normal, 90-110% standard weight (n = 137)

 

 

 

10 kg

Overweight, > 111% standard weight (n = 63)

 

 

 

7 kg

Author, year:

Schieve et al., 1999*

Total Study N:

266,172

 

 

 

Mean:

Mean:

Low BMI (n = 45,142)

 

 

0.39 kg/wk

15.2 kg

Group Description:

Low income women

Average BMI (n = 135,390)

 

 

0.38 kg/wk

15.0 kg

High BMI (n = 33,697)

 

 

0.35 kg/wk

13.8 kg

Obese (n = 51,943)

 

 

0.29 kg/wk

11.6 kg

Country:

USA

 

 

 

 

 

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Author, year:

Scholl et al., 1988

Total Study N:

696

Prepregnant relative weight (% ideal):

 

 

 

 

Group Description:

Adolescents; Delivered at 37 weeks or more gestation

Underweight, < 90% (n = 183)

 

 

 

14.5 kg

Country:

USA

Ideal, 90-119% (n = 397)

 

 

 

14.6 kg

Overweight, ≥ 120% (n = 116)

 

 

 

14.7 kg

Author, year:

Scholl et al., 1995*

Total Study N:

274

Low gain

 

 

 

10.2 kg

< 34 kg/wk (n = 59)

 

 

 

 

Group Description:

Low SES 12-29 years

Moderate gain (n = 138)

 

 

 

13.3 kg

Country:

USA

Excessive gain

 

 

 

20.0 kg

> 0.68 kg/wk (n = 77)

 

 

 

 

Author, year:

Segel and McAnarney, 1994

Total Study N:

55

Rapid gain (n = 30)

 

 

 

> 0.40 kg/wk

 

Average gain (n = 15)

 

 

 

0.23-0.40 kg/wk

Group Description:

Teens, Black

Slow gain (n = 10)

 

 

 

< 0.23 kg/wk

Country:

USA

 

 

 

 

 

Author, year:

Siega-Riz et al., 1994*

Total Study N:

8,736

BMI < 19.8

1.60 kg

0.57 kg/wk

0.52 kg/wk

 

BMI 19.8-26

1.03 kg

0.56 kg/wk

0.54 kg/wk

 

BMI 26-29

0.74 kg

0.49 kg/wk

0.51 kg/wk

 

BMI > 30

0.78 kg

0.43 kg/wk

0.52 kg/wk

 

Country:

USA

 

 

 

 

 

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Study Description

Population Characteristics

Study Criteria

Weight Gain by Trimester

Total Weight Gain

1st

2nd

3rd

Author, year:

Siega-Riz et al., 1996

Total Study N:

9,651

Preterm deliveries (n = 517)

1.4 kg

0.51 kg/wk

0.50 kg/wk

 

Term deliveries (n = 7,072)

1.2 kg

0.53 kg/wk

0.53 kg/wk

Group Description:

80% Hispanic

Country:

USA

Author, year:

Stevens-Simon and McAnarney, 1992*

Total Study N:

141

Weight Gain:

 

 

 

 

Slow, < 0.28 kg/wk (n = 23)

0.16 kg/wk

6.50 kg

Group Description:

Teens, Black

Average, 0.28-0.45 kg/wk (n = 87)

0.32 kg/wk

13.3 kg

Rapid, > 0.45 kg/wk (n = 31)

0.56 kg/wk

22.7 kg

Country:

USA

Author, year:

Soltani and Fraser, 2000*

Total Study N:

77

Normal weight (n = 29)

 

 

 

11.0 kg

Overweight (n = 23)

11.9 kg

Obese (n = 25)

9.7 kg

Country:

UK

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Author, year:

Takimoto, 2006*

Total Study N:

46,659

 

 

 

 

9.9 kg

Group Description:

Low risk deliveries

 

 

 

 

 

Country:

Japan

 

 

 

 

 

Author, year:

Tsukamoto et al., 2007

Total Study N:

3,071

BMI < 18 (n = 493)

 

 

 

10.5 kg

BMI 18-24 (n = 2,301)

 

 

 

9.8 kg

BMI > 24.0 (n = 277)

 

 

 

6.6 kg

Country:

Japan

 

 

 

 

 

Author, year:

Villamor et al., 1998

Total Study N:

432

Maternal Height

 

 

 

Predicted weight gain (mean):

140-155 cm

 

 

 

0.39 kg/wk

156-160 cm

 

 

 

0.48 kg/wk

161-165 cm

 

 

 

0.44 kg/wk

166-170 cm

 

 

 

0.47 kg/wk

Country:

Isreal

171-180 cm

 

 

 

0.69 kg/wk

NOTES: First trimester, 0-13 weeks; Second trimester, 13-26 weeks; Third trimester, 27-40 weeks. PPWR = Postpartum weight retention.

*Indicates that study is included in the systematic literature review conducted by Viswanathan et al., 2008.

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

TABLE C-1B Maternal Weight Gain in Singleton Pregnancies (by percent of BMI and gain category)

Study Description

Population Characteristics

Weight/BMI Category

Weight Gain (percent of n)

Author, year:

Cogswell et al., 1995

Total Study N:

53,541

 

Gained<6.8 kg:

BMI 19.8-26

6%

BMI > 26-29

11%

Group Description:

Low income women

BMI > 29

25%

Country:

USA

 

Gained 6.8-8.6 kg:

BMI 19.8-26

6%

BMI > 26-29

8%

BMI 19.8-26 (n = 33,809)

BMI > 29

10%

 

 

Gained 9.1-10.9 kg:

BMI > 26-29 (n = 7,661)

BMI 19.8-26

11%

BMI > 26-29

13%

BMI > 29 (n = 12,071)

BMI > 29

13%

 

 

Gained 11.4-13.2 kg:

 

BMI 19.8-26

14%

 

BMI > 26-29

13%

 

BMI > 29

13%

 

 

Gained 13.6-15.4 kg:

 

BMI 19.8-26

17%

 

BMI > 26-29

16%

 

BMI > 29

12%

 

 

Gained 15.9-17.7 kg:

 

BMI 19.8-26

14%

 

BMI > 26-29

11%

 

BMI > 29

8%

 

 

Gained> 18.2 kg:

 

BMI 19.8-26

31%

 

BMI > 26-29

28%

 

BMI > 29

19%

Author, year:

Hickey et al., 1993*

Total Study N:

1,168

 

Gained within IOM recommendations:

Black women, pregravid BMI:

Low, < 19.8 (n = 221)

37.1%

Group Description:

Low income, high risk women

Normal, 19.8-26.0 (n = 350)

30.9%

High, > 26.0-29.0 (n = 84)

27.4%

Country:

USA

White women, pregravid BMI:

 

Black (n = 803)

Low, < 19.8 (n = 118)

37.3%

White (n = 365)

Normal, 19.8-26.0 (n = 168)

35.7%

 

High, > 26.0-29.0 (n = 29)

20.7%

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Study Description

Population Characteristics

Weight/BMI Category

Weight Gain (percent of n)

Author, year:

Kiel et al., 2007*

Total Study N:

120,170

 

Gain of less than 0.9 kg:

BMI 30-34.9

3%

BMI 35-39.9

8%

Group Description:

Obese women

BMI ≥ 40

15%

Country:

USA

 

Gain of 0.9-6.4 kg:

BMI 30-34.9

15%

BMI 30-34.9 (n = 70,536)

BMI 35-39.9

22%

BMI ≥ 40

25%

BMI 35-39.9 (n = 30,609)

 

Gain of 6.5-11.4 kg:

BMI 30-34.9

26%

BMI ≥ 40 (n = 19,025)

BMI 35-39.9

27%

BMI ≥ 40

25%

 

 

Gain of > 11.4 kg:

 

BMI 30-34.9

56%

 

BMI 35-39.9

43%

 

BMI ≥ 40

35%

Author, year:

Nohr et al., 2007*

Total Study N:

62,167

 

Gain of 0.28 kg/wk:

BMI < 18.5

15.3%

BMI 18.5-24.9

11.5%

BMI 25-29.9

19.6%

BMI 30+

36.1%

Country:

Sweden

 

Gain of 0.28-0.68 kg/wk:

BMI < 18.5

71.0%

BMI 18.5-24.9

72.2%

BMI 25-29.9

62.1%

BMI 30+

49.6%

 

Gain of > 0.68 kg/wk:

BMI < 18.5

13.7%

BMI 18.5-24.9

16.3%

BMI 25-29.9

18.3%

BMI 30+

14.2%

Author, year:

Schieve et al., 2000*

Total Study N:

3,511

 

Gained < 0.23 kg/wk:

Low BMI

4%

Average BMI

5%

High BMI

23%

 

Gained 0.23-0.68 kg/wk:

Low BMI

78%

Country:

USA

Average BMI

74%

High BMI

63%

 

Gained > 0.68 kg/wk:

Low BMI

18%

Average BMI

21%

High BMI

14%

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Study Description

Population Characteristics

Weight/BMI Category

Weight Gain (percent of n)

Author, year:

Stotland et al., 2006*

Total Study N:

15,101

Low and Normal BMIs

Gain of < 0.27 kg/wk:

11%

Gain of 0.27-0.52 kg/wk:

68.2%

Gain of > 0.27 kg/w:

21.1%

Country:

USA

 

Author, year:

Taffel et al., 1993

Total Study N:

1,707

 

Actual Gain < 10 kg:

BMI < 19.8

13%

BMI 19.8-26

16%

Group Description:

BMI > 26

38%

Country:

USA

BMI < 19.8 (n = 379)

 

Actual Gain 10-12.3 kg:

BMI < 19.8

21%

BMI 19.8-26

19%

BMI 19.8-26 (n = 1,024)

BMI > 26

19%

BMI > 26 (n = 304)

 

Actual Gain > 12.3 kg:

BMI < 19.8

66%

 

BMI 19.8-26

64%

 

BMI > 26

42%

Author, year:

Wen et al., 1990*

Total Study N:

17,149

Weights (kg): < 50, 50-60, 61-72, 73-84, ≥ 85

Gained < 0.24 kg/wk: 12%

Group Description:

Black and White indigent women

 

Gained 0.24-0.57 kg/wk: 54%

Country:

USA

 

Gained 0.58-0.74 kg/wk: 19%

 

 

Gained ≥ 0.75 kg/wk: 14%

*Indicates that study is included in the systematic literature review conducted by Viswanathan et al., 2008.

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

TABLE C-2 Maternal Weight Gain in Twin and Triplet Pregnancies (by trimester and total weight gain)

Author (Year)

Population Characteristics

Study Criteria

Weight Gain by Trimester

Total Weight Gain

1st

2nd

3rd

Twins

 

 

 

 

 

 

Author, year:

Brown and Schloesser, 1990

Total Study N:

203,768

Prepregnancy Weight Status:

 

 

 

 

Twins

 

 

 

 

Group Description:

Twins (n = 1,984)

Singletons (n = 201,784)

Underweight

 

 

 

17.9 kg

Country:

USA

Normal weight

 

 

 

16.9 kg

Overweight

 

 

 

17.0 kg

Obese

 

 

 

15.2 kg

Very obese

 

 

 

12.7 kg

Singletons

 

 

 

 

Underweight

 

 

 

13.5 kg

Normal weight

 

 

 

13.8 kg

Overweight

 

 

 

13.9 kg

Obese

 

 

 

12.6 kg

Very obese

 

 

 

11.0 kg

Author, year:

Fenton et al., 1994

Total Study N:

100

 

 

 

To 34 wks

 

Birth weight:

 

 

 

 

Country:

Canada

Group Description:

Normal weight women (BMI = 19-28), aged 20-35

> 3 kg

 

 

15.50 kg

 

Intermediate

 

 

13.37 kg

 

SGA

 

 

14.66 kg

 

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Author (Year)

Population Characteristics

Study Criteria

Weight Gain by Trimester

Total Weight Gain

1st

2nd

3rd

Author, year:

Lantz et al., 1996

Total Study N:

163

BMI Categories:

 

 

 

 

Overall

 

 

 

14.7 kg

Country:

USA

Group Description:

White women (n = 112)

Black women (n = 51)

< 19.8

 

 

 

17.7 kg

19.8-26.0

 

 

 

15.6 kg

> 26.0

 

 

 

14.8 kg

Author, year:

Luke et al., 1991

Total Study N:

275

Parity and Age:

 

 

 

 

Primiparas

 

 

 

 

Country:

USA

Group Description:

White women, delivered twins (term and preterm)

18-24 years

 

 

 

19.4

25-34 years

 

 

 

18.5

35-44 years

 

 

 

22.8

Multiparas

 

 

 

 

18-24 years

 

 

 

22.3

25-34 years

 

 

 

20.4

35-44 years

 

 

 

16.8

Author, year:

Luke et al., 1992

Total Study N:

270

Pregravid BMI and birth weight categories:

 

 

 

 

 

Before 24 wks

After 24 wks

 

All BMIs

 

 

 

 

Country:

USA

< 2,500 g (n = 105)

 

0.41 kg/wk

0.49 kg/wk

15.01 kg

≥ 2,500 g (n = 58)

 

0.43 kg/wk

0.65 kg/wk

19.28 kg

Underweight BMI < 19.8

 

 

 

 

< 2,500 g (n = 26)

 

0.39 kg/wk

0.49 kg/wk

14.74 kg

≥ 2,500 g (n = 14)

 

0.44 kg/wk

0.66 kg/wk

19.78 kg

Normal weight BMI 19.8-26.0

 

 

 

 

< 2,500 g (n = 63)

 

0.39 kg/wk

0.51 kg/wk

14.70 kg

≥ 2,500 g (n = 36)

 

0.43 kg/wk

0.65 kg/wk

19.01 kg

Overweight BMI > 26.0

 

 

 

 

< 2,500 g (n = 16)

 

0.51 kg/wk

0.42 kg/wk

16.65 kg

≥ 2,500 g (n = 8)

 

0.42 kg/wk

0.68 kg/wk

19.73 kg

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Author, year:

Luke and Leurgans, 1996

Total Study N:

924

Ideal outcomea (n = 148)

 

 

 

20.3 kg

Non-ideal outcome (n = 776)

 

 

 

18.6 kg

Group Description:

Data collected during Twins Days Festival

 

 

 

 

 

Country:

USA

 

 

 

 

 

Author, year:

Pederson et al., 1989

Total Study N:

217

Optimum Outcomeb

 

 

 

Mean:

Percent ideal body weight:

 

 

 

 

Group Description:

Mostly white women, all > 18 years of age

< 90%

 

 

 

19.1 kg

90-120%

 

 

 

21.8 kg

Country:

USA

> 120%

 

 

 

15.0 kg

Less-than-optimum Outcome

 

 

 

 

Percent ideal body weight:

 

 

 

 

< 90%

 

 

 

18.2 kg

90-120%

 

 

 

17.3 kg

> 120%

 

 

 

12.3 kg

Author, year:

Yeh and Shelton, 2007

Total Study N:

1,342

Prepregnancy BMI:

 

 

 

 

< 19.8 (n = 127)

 

 

 

19.1 kg

19.8-26.0 (n = 649)

 

 

 

18.1 kg

26.1-29.0 (n = 185)

 

 

 

17.2 kg

Country:

USA

> 29.0 (n = 381)

 

 

 

14.3 kg

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Author (Year)

Population Characteristics

Study Criteria

Weight Gain by Trimester

Total Weight Gain

1st

2nd

3rd

Triplets

Total Study N:

56

Prepregnancy BMI:

 

 

 

Median:

Author, year:

Eddib et al., 2007

< 19.8 (n = 5)

 

 

 

15.5 kg

Country:

USA

Group Description:

Triplet gestations

19.8-26.0 (n = 24)

 

 

 

21.8 kg

> 26.0 (n = 27)

 

 

 

15.0 kg

Adverse Maternal Outcome present (yes/no)?

 

 

 

 

Gestational diabetes:

 

 

 

 

No (n = 53, BMI 25.8)

 

 

 

17.3 kg

Yes (n = 3, BMI 37.6)

 

 

 

15.5 kg

Gestational hypertension:

 

 

 

 

No (n = 51, BMI 25.8)

 

 

 

17.7 kg

Yes (n = 5, BMI 36.8)

 

 

 

15.5 kg

Preeclampsia:

 

 

 

 

No (n = 49, BMI 25.8)

 

 

 

15.9 kg

Yes (n = 7, BMI 28.1)

 

 

 

17.3 kg

Author, year:

Luke et al., 1995

Total Study N:

38

Gestation categories:

 

Before 24 wks

After 24 wks

19.91 kg

27-30 wks

 

0.51kg/wk

0.77kg/wk

 

31-34 wks

 

0.50kg/wk

1.08kg/wk

 

Country:

USA

35-37 wks

 

0.44kg/wk

0.90kg/wk

 

Total

 

0.48kg/wk

0.96kg/wk

 

NOTE: First trimester, 0-13 weeks; Second trimester, 13-26 weeks; Third trimester, 27-40 weeks.

aIdeal outcome is defined as mean birth weight between 2,000 and 2,800 g and gestation between 35-38 weeks.

bOptimum outcome was defined as a pregnancy resulting in two living infants with birth weights ≥ 2,500g, Apgar scores ≥ 7 at 5 minutes, and Dubowitz scores > 37 weeks.

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

TABLE C-3A Summary of Adjusted and Unadjusted* Rates of Maternal Weight Gain by Trimesters, by Pregravid BMI Status for Mothers of Twins at Gestational Ages 37-42 Wk, and with Average Twin Birth weight > 2,500 g

Pregravid BMI

Rates of Weight Gain

2-13 wks

14-26 wks

27-delivery

kg/wk

lb/wk

kg/wk

lb/wk

kg/wk

lb/wk

Normal weighta (n = 409)

0.33 ± 0.02

0.73 ± 0.05

0.77 ± 0.02

1.70 ± 0.04

0.67 ± 0.01

1.47 ± 0.03

(0.32 ± 0.32)*

(0.71 ± 0.70)*

(0.78 ± 0.24)*

(1.72 ± 0.54)*

(0.68 ± 0.27)*

(1.49 ± 0.60)*

Overweightb (n = 154)

0.20 ± 0.04

0.43 ± 0.09

0.72 ± 0.03

1.58 ± 0.06

0.61 ± 0.02

1.35 ± 0.05

(0.20 ± 0.32)*

(0.43 ± 0.70)*

(0.71 ± 0.20)*

(1.56 ± 0.43)*

(0.61 ± 0.28)*

(1.35 ± 0.62)*

Obesec (n = 143)

0.18 ± 0.04

0.39 ± 0.10

0.45 ± 0.03

1.0 ± 0.07

0.58 ± 0.03

1.28 ± 0.06

(0.20 ± 0.44)*

(0.44 ± 0.97)*

(0.44 ± 0.27)*

(0.98 ± 0.60)*

(0.57 ± 0.33)*

(1.26 ± 0.73)*

NOTES: Results are presented as least square means ± SEM from models controlling for diabetes and gestational diabetes, preeclampsia, smoking during pregnancy, primiparity, and placental membranes (monochorionicity and missing chorionicity). Rates for the 1st trimester are calculated post-conception, using 2 post-menstrual weeks as the average for time of conception. Results in parentheses are the unadjusted means ± SD.

aBMI = 18.5-24.9 kg/m2.

bBMI = 25.0-29.9 kg/m2.

cBMI = ≥ 30 kg/m2.

SOURCE: Historical cohort of twin births delivered at John Hopkins Hospital, Baltimore, Jackson Memorial Hospital, Miami, Medical University of South Carolina, Charleston, and University of Michigan, Ann Arbor provided by Barbara Luke, Sc.D., M.P.H., R.D., and Mary L. Hediger, Ph.D. For more details on this historical cohort, see Luke et al., 2003.

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

TABLE C-3B Summary of Adjusted and Unadjusted* Cumulative Gain by Trimesters, by Pregravid BMI Status for Mothers of Twins at Gestational Ages 37-42 Wk, and with Average Twin Birth weight > 2,500 g

Pregravid BMI

Cumulative Weight Gain

To 13 wks

To 26 wks

To 37-42 wks

kg/wk

lb/wk

kg/wk

lb/wk

kg/wk

lb/wk

Normal weighta (n = 409)

3.6 ± 0.3

8.0 ± 0.6

13.1 ± 0.3

28.8 ± 0.6

20.9 ± 0.3

45.9 ± 0.7

(3.5 ± 3.5)*

(7.8 ± 7.7)*

(13.2 ± 4.9)*

(29.1 ± 10.7)*

(21.0 ± 6.1)*

(46.2 ± 13.4)*

Overweightb (n = 154)

2.1 ± 0.4

4.7 ± 1.0

11.3 ± 0.4

24.8 ± 1.0

18.9 ± 0.5

41.6 ± 1.1

(2.2 ± 3.5)*

(4.8 ± 7.7)*

(11.1 ± 5.5)*

(24.4 ± 12.1)*

(18.7 ± 7.0)*

(41.1 ± 15.5)*

Obesec (n = 143)

2.0 ± 0.5

4.3 ± 1.1

8.5 ± 0.4

18.8 ± 1.0

15.7 ± 0.5

34.6 ± 1.2

(2.2 ± 4.8)*

(4.8 ± 10.6)*

(8.4 ± 5.9)*

(18.6 ± 12.9)*

(15.4 ± 7.2)*

(34.0 ± 15.9)*

NOTES: Results are presented as least square means ± SEM from models controlling for diabetes and gestational diabetes, preeclampsia, smoking during pregnancy, primiparity, and placental membranes (monochorionicity and missing chorionicity). Total cumulative gain is also adjusted for length of gestation. Results in parentheses are the unadjusted means ± SD.

a BMI = 18.5-24.9 kg/m2.

b BMI = 25.0-29.9 kg/m2.

c BMI = ≥ 30 kg/m2.

SOURCE: Historical cohort of twin births delivered at John Hopkins Hospital, Baltimore, Jackson Memorial Hospital, Miami, Medical University of South Carolina, Charleston, and University of Michigan, Ann Arbor provided by Barbara Luke, Sc.D., M.P.H., R.D., and Mary L. Hediger, Ph.D. For more details on this historical cohort, see Luke et al., 2003.

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

TABLE C-3C Interquartile Ranges of Rates of Maternal Weight Gain by Trimesters, by Pregravid BMI Status for Mothers of Twins at Gestational Ages 37-42 Weeks, and with Average Twin Birth weight > 2,500 g

Pregravid BMI

Rates of Weight Gain

2-13 wks

14-26 wks

27-delivery

kg/wk

lb/wk

kg/wk

lb/wk

kg/wk

lb/wk

Normal weighta (n = 409)

0.12-0.49

0.27-1.07

0.64-0.94

1.40-2.06

0.50-0.83

1.09-1.83

Overweightb (n = 154)

0.03-0.39

0.06-0.85

0.57-0.87

1.25-1.91

0.42-0.81

0.92-1.79

Obesec (n = 143)

0.08-0.34

0.18-0.76

0.24-0.63

0.54-1.39

0.34-0.70

0.75-1.55

NOTES: Results are presented as the 25th-75th percentiles for the rates or cumulative gain over the interval. Rates for the 1st trimester are calculated post-conception, using 2 post-menstrual weeks as the average for time of conception.

a BMI = 18.5-24.9 kg/m2.

b BMI = 25.0-29.9 kg/m2.

c BMI = ≥ 30 kg/m2.

SOURCE: Historical cohort of twin births delivered at John Hopkins Hospital, Baltimore, Jackson Memorial Hospital, Miami, Medical University of South Carolina, Charleston, and University of Michigan, Ann Arbor provided by Barbara Luke, Sc.D., M.P.H., R.D., and Mary L. Hediger, Ph.D. For more details on this historical cohort, see Luke et al., 2003.

TABLE C-3D Interquartile Ranges of Cumulative Gain by Trimesters, by Pregravid BMI Status for Mothers of Twins at Gestational Ages 37-42 Weeks, and with Average Twin Birth weight > 2,500 g

Pregravid BMI

Cumulative Weight Gain

To 13 wks

To 26 wks

To 37-42 wks

kg/wk

lb/wk

kg/wk

lb/wk

kg

lbs

Normal weighta (n = 409)

1.4-5.4

3.0-11.8

10.0-16.4

22.0-36.0

16.8-24.5

37-54

Overweightb (n = 154)

0.3-4.3

0.7-9.4

7.7-14.1

17.0-31.0

14.1-22.7

31-50

Obesec (n = 143)

0.9-3.8

2.0-8.4

4.9-11.4

10.7-25.0

11.4-19.1

25-42

NOTES: Results are presented as the 25th-75th percentiles for the rates or cumulative gain over the interval.

a BMI = 18.5-24.9 kg/m2.

b BMI = 25.0-29.9 kg/m2.

c BMI = ≥ 30 kg/m2.

SOURCE: Historical cohort of twin births delivered at John Hopkins Hospital, Baltimore, Jackson Memorial Hospital, Miami, Medical University of South Carolina, Charleston, and University of Michigan, Ann Arbor provided by Barbara Luke, Sc.D., M.P.H., R.D., and Mary L. Hediger, Ph.D. For more details on this historical cohort, see Luke et al., 2003.

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

TABLE C-4 Maternal Weight Gain and Body Composition

Author (Year)

Population/Study Characteristics

Study Criteria

Body Composition Measurements (FFM, FM, TBW)

Author, year:

Bronstein et al., 1996

Total Study N:

33

Pregnant women (n = 16)

FFM at 31-35 weeks: 55.5 kg

FM at 31-35 weeks: 32.8 kg

Group Description:

Non-pregnant and pregnant women [BC by densitometry}

Non-pregnant women (n = 17)

FFM at study: 50.1 kg

FM at study: 29.8 kg

Country:

USA

Author, year:

Butte et al., 2003*

Total Study N:

63

 

GWG

Low BMI

Normal BMI

High BMI

Group Description:

BMI Categories:

Low, BMI < 19.8 (n = 17)

Normal, BMI 19.8-26 (n = 34)

High, BMI > 26 (n = 12)

TBW

Low BMI

Normal BMI

High BMI

Country:

USA

FFM

Low BMI

Normal BMI

High BMI

[BC by TBK 4 compartment method]

FM

Low BMI

Normal BMI

High BMI

Net GWG

Low BMI

Normal BMI

High BMI

GWG per wk

Low BMI

Normal BMI

High BMI

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Pregravid Weight/Body Comp

Weight Gain/Body Composition by Trimester

Total Weight Gain

Postpartum Weight/Body Composition

1st

2nd

3rd

75.7 kg

 

 

 

 

 

79.9 kg

 

 

 

 

 

 

9 wks

22 wks

36 wks

 

 

49.9 kg

51.9 kg

57.7 kg

63.0 kg

15.0 kg

 

59.3 kg

60.2 kg

65.1 kg

72.2 kg

14.5 kg

 

77.3 kg

81.8 kg

85.8 kg

93.8 kg

17.9 kg

 

28.7 kg

28.7 kg

32.2 kg

34.7 kg

 

 

32.0 kg

31.6 kg

34.1 kg

38.7 kg

 

 

35.6 kg

35.7 kg

37.9 kg

42.8 kg

 

 

39.0 kg

39.6 kg

42.6 kg

46.9 kg

 

 

43.1 kg

43.0 kg

46.0 kg

51.4 kg

 

 

47.8 kg

48.9 kg

51.0 kg

56.9 kg

 

 

10.9 kg

12.4 kg

15.1 kg

16.1 kg

 

 

16.8 kg

17.2 kg

19.1 kg

21.0 kg

 

 

309 kg

33.0 kg

34.8 kg

37.0 kg

 

 

 

 

 

 

11.6 kg

 

 

 

 

 

11.0 kg

 

 

 

 

 

14.1 kg

 

 

 

 

 

0.40 kg/wk

 

 

 

 

 

0.37 kg/wk

 

 

 

 

 

0.45 kg/wk

 

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Author (Year)

Population/Study Characteristics

Study Criteria

Body Composition Measurements (FFM, FM, TBW)

Author, year:

Catalano et al., 1998

Total Study N:

16

Ab GT (n = 6)

Controls (n = 10)

Pregravid measurements

Group Description:

Women with normal and abnormal glucose tolerance (Ab GT); Ab GT (n = 6), Controls (n = 10) [BC by densitometry]

FFM:

46.4 kg

46.3 kg

FM:

12.8 kg

10.2 kg

Country:

USA

Sum of 7 site skinfolds:

88.7 mm

74.0 mm

Author, year:

Ehrenberg et al., 2003

Total Study N:

52

 

 

Lean (n = 17)

Obese (n = 35)

GDM/obese (n = 14)

CTL/obese (n = 21)

Group Description:

Women with GDM (lean, n = 5; obese, n = 14)

Country:

USA

Women with normal glucose tolerance (lean, n = 12; obese, n = 21)

[Underwater weighing]

Author, year:

Forsum et al., 2006

Total Study N:

23

Healthy women, parity 0-2 and planning pregnancy

 

Body weight Total body fat FFM

Group Description:

Adults

[BC of mothers by 2 compartment method (TBW)]

Country:

Sweden

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Pregravid Weight/Body Comp

Weight Gain/Body Composition by Trimester

Total Weight Gain

Postpartum Weight/Body Composition

1st

2nd

3rd

 

12-14 wks

Weight:

 

34-36 wks

Weight:

 

 

59.2 kg

60.5 kg

 

71.6 kg

 

 

56.5 kg

59.9 kg

 

70.0 kg

 

 

 

FFM:

 

FFM:

 

 

 

46.4 kg

 

53.4 kg

 

 

 

46.8 kg

 

53.6 kg

 

 

 

FM:

 

FM:

 

 

 

14.1 kg

 

18.2 kg

 

 

 

13.2 kg

 

16.5 kg

 

 

 

Sum of 7 site skinfolds:

93.5 mm

89.0 mm

 

Sum of 7 site skinfold:

108.9 mm

109.8 mm

 

 

 

 

 

 

 

FM gain

56.2 kg

 

 

 

12.3 kg

4.7 kg

67.6 kg

 

 

 

13.0 kg

4.2 kg

69.7 kg

 

 

 

12.0 kg

3.2 kg

66.3 kg

 

 

 

13.7 kg

4.8 kg

 

 

 

32 wks:

 

2 wks pp:

67.4 kg

 

 

79.3 kg

18.1 kg

73.5 kg

22.6 kg

 

 

27.0 kg

3.9 kg

26.7 kg

44.6 kg

 

 

 

 

 

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Author (Year)

Population/Study Characteristics

Study Criteria

Body Composition Measurements (FFM, FM, TBW)

Author, year:

Kopp-Hoolihan et al., 1999

Total Study N:

9

 

 

 

Body weight

Group Description:

Healthy, non-smokers planning a pregnancy

 

TBW

 

TBW/FFM

 

TBBM

 

FFM

Country:

USA

 

FM

 

Mean wt gain

 

Mean fat gain % wt as FM

Author, year:

Lederman et al., 1997*

Total Study N:

196

BMI/Gain Categories

 

Body water gain:

Group Description:

Hispanic, White and Black women

BMI < 19.8

 

Total (n = 21)

6.1 L

< rec (n = 6)

6.4 L

Country:

USA

Aged 18-35 years

[BC by 4-compartment method]

rec (n = 7)

5.9 L

> rec (n = 8)

6.1 L

BMI 19.8-26

 

Total (n = 118)

7.0 L

< rec (n = 31)

6.2 L

rec (n = 46)

6.9 L

> rec (n = 41)

7.6 L

BMI > 26-29

 

Total (n = 29)

7.8 L

< rec (n = 7)

6.9 L

rec (n = 9)

5.7 L

> rec (n = 13)

9.7 L

BMI > 29

 

Total (n = 28)

7.3 L

< rec (n = 7)

7.8 L

rec (n = 6)

6.0 L

> rec (n = 15)

7.6 L

Author, year:

Lof and Forsum, 2004

Total Study N:

17

Pregnant women

 

 

Body weight

Group Description:

Adults

 

TBW

 

FFM

 

FM

[BC by deuterium dilution underwater weighing]

 

 

Country:

Sweden

 

 

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Pregravid Weight/Body Comp

Weight Gain/Body Composition by Trimester

Total Weight Gain

Postpartum Weight/Body Composition

1st

2nd

3rd

 

8-10 wks

24-26 wks

34-36 wks

 

4-6 wks

64.7 kg

64.9 kg

72.1 kg

75.9 kg

 

68.0 kg

33.5 kg

33.9 kg

36.5 kg

39.1 kg

 

33.8 kg

0.72

0.73

0.74

0.74

 

0.72

2525 g

 

2463 g

46.3 kg

46.7 kg

49.7 kg

52.8 kg

 

46.7 kg

20.2 kg

20.3 kg

24.4 kg

24.3 kg

 

22.0 kg

0.19 kg

7.23 kg

3.76 kg

11.2 kg

0.10 kg

4.10 kg

−0.10 kg

4.20 kg

53.00

57.00

−3.00

Fat gain:

63.4 kg

 

 

 

 

4.8 kg

 

 

 

 

12.60 kg

0.6 kg

 

 

 

 

7.90 kg

6.0 kg

 

 

 

 

12.60 kg

6.9 kg

 

 

 

 

16.10 kg

3.9 kg

 

 

 

 

12.2 kg

1.3 kg

 

 

 

 

8.60 kg

3.8 kg

 

 

 

 

12.1 kg

6.0 kg

 

 

 

 

15.2 kg

2.8 kg

 

 

 

 

11.0 kg

0.3 kg

 

 

 

 

8.50 kg

2.8 kg

 

 

 

 

9.10 kg

4.2 kg

 

 

 

 

13.6 kg

0.2 kg

 

 

 

 

8.70 kg

−5.2kg

 

 

 

 

3.20 kg

−0.6kg

 

 

 

 

6.9 kg

3.1 kg

 

 

 

 

12.0 kg

 

 

Week 14

Week 32

 

2 wk pp:

66.6 kg

 

68.4 kg

77.3 kg

16.7 kg

71.5 kg

31.5 kg

 

32.5 kg

38.1 kg

 

33.6 kg

43.9 kg

 

44.9 kg

51.0 kg

 

45.7 kg

22.7 kg

 

23.5 kg

26.3 kg

 

25.8 kg

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Author (Year)

Population/Study Characteristics

Study Criteria

Body Composition Measurements (FFM, FM, TBW)

Author, year:

Okereke et al., 2004

Total Study N:

15

 

WT

NGT (n = 8)

 

Group Description:

Obese women

GDM (n = 7)

 

 

FFM

NGT

 

GDM

 

Country:

USA

 

FM

NGT

 

GDM

 

Author, year:

Stevens-Simon et al., 1997

Total Study N:

108

 

 

Teens < 16 yrs

WT

Group Description:

Teens, Black [All weights are net wt Total body potassium]

 

LBM

 

FM

Teens 16-18 yrs

WT

Country:

USA

 

LBM

 

FM

NOTE: First trimester, 0-13 weeks; Second trimester, 13-26 weeks; Third trimester, 27-40 weeks. GDM = gestational diabetes mellitus; FFM = fat-free mass; FM = fat mass; TBW = total body weigh; NGT = normal glucose tolerance; WT = weight.

*Indicates that study is included in the systematic literature review conducted by Viswanathan et al., 2008.

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

Pregravid Weight/Body Comp

Weight Gain/Body Composition by Trimester

Total Weight Gain

Postpartum Weight/Body Composition

1st

2nd

3rd

 

12-14 wks

 

34-36 wks

 

 

71.4 kg

73.2 kg

 

84.1 kg

 

 

78.2 kg

79.6 kg

 

89.5 kg

 

 

49.4 kg

50.1 kg

 

55.2 kg

 

 

51.7 kg

52.1 kg

 

56.8 kg

 

 

22.0 kg

23.1 kg

 

28.9 kg

 

 

26.5 kg

27.5 kg

 

32.7 kg

 

 

 

 

15-16 wks

34-35 wks

 

 

59.7 kg

 

61.6 kg

68.3 kg

 

 

 

 

46.6 kg

50.8 kg

 

 

 

 

15.0 kg

17.50 kg

 

 

61.7 kg

 

63.9 kg

69.6 kg

 

 

 

 

47.8 kg

51.2 kg

 

 

 

 

16.1 kg

18.3 kg

 

 

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

TABLE C-5 Mean Weights and Percentiles for Placentas (singletons, twins, and triplets)

Gestational age (weeks)

90th Percentile

Mean Placental Weight

10th Percentile

Cases (n)

Singletons

Twins

Triplets

Singletons

Twins

Triplets

Singletons

Twins

Triplets

Singletons

Twins

Triplets

19

263

212

161

2

20

270

285

218

253

166

226

3

3

21

172

286

320

143

231

284

114

176

257

3

2

2

22

191

310

345

157

251

319

122

191

289

6

5

2

23

211

343

400

172

276

361

133

210

331

7

2

3

24

233

382

445

189

307

406

145

232

371

9

3

5

25

256

426

498

208

341

456

159

257

408

19

5

6

26

280

475

558

227

380

509

175

284

444

14

4

6

27

305

528

630

248

421

564

192

314

480

9

8

4

28

331

584

697

270

464

621

210

345

516

16

7

5

29

357

641

772

293

509

679

229

377

553

11

12

6

30

384

700

849

316

554

738

249

409

591

12

17

10

31

411

758

925

340

600

797

269

441

631

14

13

15

32

438

815

1,000

364

644

855

290

472

674

24

29

7

33

464

870

1,072

387

687

911

311

503

719

30

27

14

34

491

923

1,139

411

727

965

331

531

768

32

53

43

35

516

971

1,200

434

764

1,017

352

558

821

44

52

33

36

542

1,014

1,253

457

798

1,065

372

582

878

36

66

19

37

566

1,051

1,297

478

827

1,108

391

602

940

32

58

8

38

589

1,082

1,330

499

850

1,147

409

619

1,007

62

54

5

39

611

1,105

519

868

426

631

103

38

40

632

1,118

537

879

442

639

193

47

41

651

1,123

553

882

456

642

8 7

1 2

SOURCES: Pediatric Pathology & Laboratory Medicine by Pinar H., C. J. Sung, C. E. Oyer and D. B. Singer. Copyright 1996 by Informa Clinical Medicine—Journals. Reproduced with permission of Informa Clinical Medicine—Journals via Copyright Clearance Center; Reprinted from Pinar H., M. Stephens, D. B. Singer, T. K. Boyd, S. M. Pflueger, D. L. Gang, D. J. Roberts and C. J. Sung. 2002. Triplet placentas: reference values for weights. Pediatric and Developmental Pathology 5(5): 495-498 with kind permission from Springer Science and Business Media.

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

TABLE C-6 DNA, Glycogen, and Lipid Content in Placentas from Normal and Diabetic Human Pregnancies

Pregnancy

Placental Weight (g)

Placental DNA

Placental Glycogen

Placental Lipid Triglycerides

(mg/g)

(g/total placenta)

(mg/g)

(mg/mg DNA)

(g/total placenta)

(μmol/g)

(μmol/mg DNA)

(mmol/total placenta)

Normal (n = 50)

550 ± 28

2.54 ± 0.13

1.40 ± 0.07

8.4 ± 0.5

3.3 ± 0.3

4.67 ± 0.29

2.51 ± 0.16

0.98 ± 0.15

1.38 ± 0.10

Gestational diabetes (n = 23)

664 ± 60

2.58 ± 0.24

1.71a ± 0.12

9.9 ± 0.8

3.8 ± 0.4

6.57a ± 0.60

3.32a ± 0.31

1.29 ± 0.20

2.20a ± 0.25

Insulin-treated diabetes (n = 12)

615 ± 110

3.04 ± 0.32

1.87a ± 0.20

14.9b ± 1.9

4.9a ± 0.3

9.16b ± 0.88

4.56b ± 0.70

1.50 ± 0.16

2.80b ± 0.41

NOTE: Values in the table are means ± SE for number of patients indicated in parentheses.

a Significant difference from value for normal pregnancy (p < 0.05).

b Significant difference from value for normal pregnancy (p < 0.01).

SOURCE: Modified from Diamant et al., 1982. This information was published in the American Journal of Obstetrics and Gynecology, Vol 144, Diamant Y. Z., B. E. Metzger, N. Freinkel and E. Shafrir, Placental lipid and glycogen content in human and experimental diabetes mellitus, Pages 5-11, Copyright Elsevier (1982).

Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×

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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
×
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Suggested Citation:"Appendix C: Supplementary Information on Composition and Components of Gestational Weight Gain." Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press. doi: 10.17226/12584.
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Next: Appendix D: Summary of Determinants of Gestational Weight Gain »
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As women of childbearing age have become heavier, the trade-off between maternal and child health created by variation in gestational weight gain has become more difficult to reconcile. Weight Gain During Pregnancy responds to the need for a reexamination of the 1990 Institute of Medicine guidelines for weight gain during pregnancy. It builds on the conceptual framework that underscored the 1990 weight gain guidelines and addresses the need to update them through a comprehensive review of the literature and independent analyses of existing databases. The book explores relationships between weight gain during pregnancy and a variety of factors (e.g., the mother's weight and height before pregnancy) and places this in the context of the health of the infant and the mother, presenting specific, updated target ranges for weight gain during pregnancy and guidelines for proper measurement. New features of this book include a specific range of recommended gain for obese women.

Weight Gain During Pregnancy is intended to assist practitioners who care for women of childbearing age, policy makers, educators, researchers, and the pregnant women themselves to understand the role of gestational weight gain and to provide them with the tools needed to promote optimal pregnancy outcomes.

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