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FIGURE 5-2 Results: Proportion of women exceeding IOM weight gain guidelines.
NOTE: *OR =.38 [0.20–0.87]; p = .003].
SOURCE: Phelan et al., 2011b, p. 776. Reprinted with permission from the American Society for Nutrition.

the guidelines, while only 40 percent of those in the intervention group did; by contrast, the investigators saw no difference between the standard care and intervention groups in the percentages of overweight and obese women who exceeded the guidelines. The women had been recruited early in pregnancy (after 13 weeks of gestation on average). At recruitment, 56 percent of the normal weight and 68 percent of the overweight and obese women were already above the recommended rate of gestational weight gain for that time in the pregnancy (see Figure 5-2).

Another major finding was that once women had exceeded recommendations during pregnancy, few were able to return to a weight gain that was within the guidelines. This was seen across subgroups of weight status, both in the standard care and intervention groups. Once a woman had gained more than the recommended weight, only between 3 and 10 percent were able to get back to within the recommended weight gain rates.

Although the intervention stopped at delivery, the study saw positive effects at 6 months postpartum in both the normal-weight and the overweight and obese groups in terms of the percentage of women who had returned to their pre-pregnancy weight or less by 6 months postpartum. Among the normal-weight women, 35 percent of the intervention group returned to their pre-pregnancy weight compared with only 20 percent of



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