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Recommendations for Weight Gain During Pregnancy in the Context of the Obesity Epidemic

Rasmussen, Kathleen M. ScD; Abrams, Barbara DrPH; Bodnar, Lisa M. PhD, MPH; Butte, Nancy F. PhD; Catalano, Patrick M. MD; Maria Siega-Riz, Anna PhD

doi: 10.1097/AOG.0b013e3181f60da7
Current Commentary

The Institute of Medicine and the National Research Council have issued new guidelines for gestational weight gain as well as recommendations for action and research that call for “a radical change in the care provided to women of childbearing age.” For the first time, these guidelines consider the outcomes of both mother and child during and after delivery and the trade-offs between them. The recommendations call for women to begin pregnancy at a healthy weight and to gain within the guidelines, a goal not previously achieved. They also call for individualized preconceptional, prenatal, and postpartum care to help women attain a healthy weight, gain within the guidelines, and return to a healthy weight. Scientific evidence was inadequate to provide specific guidelines by obesity class or to support a public health recommendation to reduce the guidelines below 5-9 kg (11-20 lb) for obese women.

The 2009 weight gain recommendations call for a “radical change” in care for childbearing women and provide a specific guideline for obese women.

From the Division of Nutritional Sciences, Cornell University, Ithaca, New York; the Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California; the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; the Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas; the Department of Reproductive Biology, Case Western Reserve University, Cleveland, Ohio; and the Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina.

See related article on page 1111.

This commentary draws on the Institute of Medicine report, “Weight Gain During Pregnancy: Reexamining the Guidelines” (2009), which was supported in part by the U.S. Department of Health and Human Services and a grant from the March of Dimes Foundation. It was prepared by a committee composed of Claude Bouchard, Matthew Gillman, Fernando Guerra, Paula Johnson, Michael Lu, Elizabeth McAnarney, Rafael Perez-Escamilla, David Savitz, and the authors of this article. Any views not attributed to the report are those of the authors and do not necessarily represent the views of the Institute of Medicine.

Corresponding author: Kathleen M. Rasmussen, ScD, Professor, Division of Nutritional Sciences, Savage Hall, Cornell University, Ithaca, NY 14853; e-mail:

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

© 2010 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.