New Guidelines Urge Less Weight Gain in Pregnancy for Obese Women

Obese women (BMI, 30 or higher) should gain only 11 to 20 pounds during a singleton pregnancy, according to new guidelines from the Institute of Medicine.

The guidelines update the IOM's previous recommendations, issued in 1990. The group continues to recommend that:

• underweight women (BMI lower than 18.5) gain 28-40 pounds;

• normal-weight women (BMI, 18.5-24.9) gain 25-35 pounds;

• overweight women (BMI, 25.0-29.9) gain 15-25 pounds.

Weight gain should be higher for multiple pregnancies.

Excessive weight gain, the IOM notes, is associated with increased risk for gestational diabetes, pregnancy-associated hypertension, and delivery of large-for-gestational-age infants, among other outcomes.

The group says that clinicians should supplement these guidelines with individualized counseling about diet and exercise. In addition, preconception counseling should stress the importance of conceiving at a normal BMI.