GESTATIONAL WEIGHT-GAIN, PREGNANCY OUTCOME, AND POSTPARTUM WEIGHT RETENTION

Objective: To determine whether the risk of maternal overweight associ ated with an excessive rate of gestational gain needs to be balanced a gainst the risks of impaired fetal growth associated with a low rate o f gain. Methods: Rate of gestational weight gain was measured prospect ively in a sample of 274 young, low-income, and primarily minority wom en (12-29 years old) with pregravid body mass indices (BMI) in the nor mal range (19.8-26.0). We defined an excessive rate of gain between 20 -36 weeks' gestation as one greater than 0.68 kg/week, and a low rate of gain as one less than 0.34 kg/week. Women were followed-up at 4-6 w eeks and 6 months postpartum. Results: Rate of measured gestational ga in between 20-36 weeks' gestation was associated with total weight gai n based on pregravid weight, with infant birth weight and gestation du ration, and with maternal overweight (BMI greater than 26) and weight retention postpartum Infant birth weight and gestation duration were s ignificantly reduced for women with low rates of gain, and there was n o significant difference between women with excessive and moderate gai ns. Despite little difference in pregravid BMI, women with excessive r ates of gain retained more weight overall, attained a greater postpart um BMI, and had higher levels of subcutaneous fat and overweight. Mate rnal anthropometric status showed little change between 4-6 weeks and 6 months postpartum. Conclusion: Weight gained at an excessive rate by women with a pregravid BMI in the normal range does not greatly enhan ce fetal growth and gestation duration, contributing instead to postpa rtum maternal overweight.