Pre‐pregnancy and pregnancy‐related factors and the risk of excessive or inadequate gestational weight gain

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Abstract
Objective: Gestational weight gain consistent with the Institute of Medicine's recommendations is associated with better maternal and infant outcomes. The objective was to quantify the effect of pre‐pregnancy factors, pregnancy‐related health conditions, and modifiable pregnancy factors on the risks of inadequate and excessive gestational weight gain. Method: A longitudinal cohort of pregnant women (N = 1100) who completed questions about diet and weight gain during pregnancy and delivered a singleton, full‐term infant. Results: Gestational weight gain was inadequate for 14% and excessive for 53%. Pre‐pregnancy factors contributed 74% to excessive gain, substantially more than pregnancy‐related health conditions (15%) and modifiable pregnancy factors (11%). Pre‐pregnancy factors, pregnancy‐related health conditions, and modifiable pregnancy factors contributed fairly equally to the risk of inadequate gain. Conclusion: Interventions to prevent excessive gestational gain may need to start before pregnancy. Women at risk for inadequate gain would also benefit from interventions directed toward modifiable factors during pregnancy.