THE PATTERN OF MATERNAL WEIGHT-GAIN IN WOMEN WITH GOOD PREGNANCY OUTCOMES

Objectives. This study describes the pattern of maternal weight gain i n women with good pregnancy outcomes and provides data to fill in the provisional weight-gain charts published by the Institute of Medicine (IOM) in 1990. Methods. We selected 7002 women with good outcomes (def ined by factors related to maternal and infant health) from the Univer sity of California, San Francisco, Perinatal Database. For each body m ass index category, we compared percentiles of weight gain by trimeste r in women who achieved the IOM recommendations for total gain and tho se who did not, Results. Trimester rates of gain varied by body mass i ndex category and exceeded IOM guidelines in all groups. Forty percent of these women with good outcomes had total gains within the guidelin es and provided data to complete the IOM weight-gain charts. Conclusio ns. Most women in this good-outcome sample would have been suspected o f being at increased risk for poor outcome on the basis of their weigh t gain, This confirms the IOM recommendation that evaluation of the un derlying causes of excessively high or low weight gain during pregnanc y is necessary before appropriate interventions can be applied.