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Association of Gestational Weight Gain Expectations and Advice on Actual Weight Gain

Krukowski, Rebecca A. PhD; West, Delia S. PhD; DiCarlo, Marisha PhD; Cleves, Mario A. PhD; Saylors, Marie E. MPH; Andres, Aline PhD

doi: 10.1097/AOG.0000000000001780
Contents: Original Research
Cochrane Reviews
Clinical ObGyn

OBJECTIVE: To examine pregnant women's gestational weight gain expectations and advice from various sources (ie, self, family and friends, physician) and the association of these sources of expectations and advice with measured gestational weight gain.

METHODS: This is a secondary analysis of a cohort study of 230 pregnant women in their second pregnancy. Each woman was queried at 12 weeks of gestation about the amount of weight: 1) she felt was “healthy” to gain, 2) she expected to gain, 3) her friends and family thought she should gain, and 4) the specificity of her physician's advice about gestational weight gain. Gestational weight gain was calculated as the difference in measured weight between 4 and 10 weeks and 36 weeks of gestation. Odds ratios and corresponding 95% confidence intervals were computed for the association between excessive gestational weight gain and each question using logistic regression in this secondary analysis.

RESULTS: Participants were 87.4% Caucasian. Overweight and obese women were significantly more likely to expect excessive gestational weight gain compared with normal-weight women. Women who reported expecting to gain excessively were significantly more likely to actually gain excessively (52%; odds ratio [OR] 3.19, 95% confidence interval [CI] 1.77–5.77) than those who expected to gain within the guidelines (36%). After adjusting for self-reported gestational weight gain in the first pregnancy and sociodemographic characteristics, women who reported expecting to gain excessively were still significantly more likely to gain excessively (51%; OR 2.22, 95% CI 1.08–4.56) than those who expected to gain within guidelines (37%).

CONCLUSION: It may be particularly important to develop interventions that positively influence women's own expectations for gestational weight gain.


Self-expectations of gestational weight gain exceeding the Institute of Medicine's guidelines put women in their second pregnancy at significantly higher risk of gaining excessively.

Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; the Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; and the Arkansas Department of Health, Office of Health Communications; Pediatrics Biostatistics, the Arkansas Children's Nutrition Center, University of Arkansas for Medical Sciences, College of Medicine; the Arkansas Children's Nutrition Center, Little Rock, Arkansas; and the Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Corresponding author: Rebecca A. Krukowski, PhD, 66 N. Pauline Street, Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN Memphis, TN 38163; email:

Funded by USDA-ARS 6026-51000- 010‐05S.

Financial Disclosure The authors did not report any potential conflicts of interest.

Presented in part at the Experimental Biology meeting, March 28–April 1, 2015, Boston, Massachusetts.

The funding agency did not have a role in the conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

Each author has indicated that he or she has met the journal's requirements for authorship.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.