Healthy Weight Gain During Pregnancy Chart

According to current evidence, women who have direct,
supportive, and non-judgmental weight gain discussions
with their health care provider are more likely to stay
within the recommendations.
Women who gain weight above or below the Institute of
Medicine Pregnancy Weight Gain Guidelines are at higher
risk for complications during pregnancy and later in life.
e risks of gaining too much or too little weight can include
hypertension and diabetes in the mother, and pre-term birth,
low birth weight, and macrosomia in the infant. In addition,
there is an association with chronic disease throughout life
for both the woman and child (including obesity, hyper-
tension, and diabetes). Research shows that 50 to 70 percent
of women are gaining weight above or below the current
guidelines.
1
Healthy Weight Gain During Pregnancy:
A Clinicians Tool
Pre-pregnancy BMI Total Weight Gain 2nd and 3rd Tri. lbs./wk. 2nd and 3rd Tri. lbs./mo. Twins
Underweight <18.5 28–40 lbs. 1–1.3 lbs /week 4–6 lbs/month No guidelines
Normal weight 18.5–24.9 25–35 lbs. 0.8–1 lb week 4 lbs/month 37–54 lbs.
Overweight 25.0–29.9 15–25 lbs. 0.5–0.7 lb/week 2 lbs/month 31–50 lbs.
Obese ≥30.0 11–20 lbs* 0.4–0.5 lb/week 1.5 to 2 lbs /month 25–42 lbs.
*weight gain at lower end of range for women with a higher BMI
Table based on 2009 Institute of Medicine Pregnancy Weight Gain Guidelines
Screen
• Determinepre-pregnancyweightandheighttocalculatepre-pregnancybody
mass index (BMI).
• Determinepregnancyweightgainrecommendationbasedonpre-pregnancy
BMI and Institute of Medicine guidelines (see table above).
• PlotpregnancyweightgainonappropriateBMIweightgainchartandreview:
www.cdph.ca.gov/pubsforms/forms/Pages/MaternalandChildHealth.aspx or
http://wicworks.nal.usda.gov/pregnancy/prenatal-weight-gain
• Assesspatientandfamilyweighthistory(priorpre-pregnancyweight,pregnancy
weight gain, weight loss after delivery, family weight pattern) in addition to
patient/family medical issues, i.e., hypertension and diabetes.
Assess
• Startwithanopenendedquestion,“Aspartofourvisit,Iwouldliketotake
a few minutes to talk about weight gain during pregnancy. Tell me what you
have heard about weight gain during pregnancy?”
• enfollowupwithadditionalquestionslike,“Howmuchweightdoyou
expect to gain during this pregnancy?”
• Askwhatsheiscurrentlydoingtosupportahealthyweightgainandwhat,
if any, diet and exercise changes she has made.
• Withbusyschedules,medicalprovidersmaygiveadviceasthewomantalks,
but it saves time in the long run to listen closely rst, then provide information.
Clinical judgment
After assessing patients health
status, weight gain, diet, and
fetal growth, the Institute of
Medicine expects providers to
use professional judgment in
assessing individual patients.
For example, low or no weight
gain may be adequate for a
woman with a pre-pregnancy
BMI of 37 who is eating healthy,
walking, and has good fetal
growth and no other problems.
If weight gain exceeds the
guidelines, consider the overall
weight gain pattern/trends as
well as factors such as multiple
gestations and the composition
of weight gain (e.g., uids, tissues).
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ReferenceRasmussen,KathleenM.,PatrickM.Catalano,andAnnL.Yaktine.New Guidelines
for Weight Gain During Pregnancy: What Obstetricians/Gynecologists Should Know. Current
OpinioninObstetricsandGynecology21(2009):521-26.
Do not wait to start
the conversation
Waiting until there is a weight gain
issue can make the conversation
and subsequent behavior change
more dicult.
Page 1/2
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