Implications of the Institute of Medicine weight gain recommendations for preventing adverse pregnancy outcomes in black and white women

Am J Public Health. 1998 Aug;88(8):1168-74. doi: 10.2105/ajph.88.8.1168.


Objectives: This study examined the relation between gestational weight gain and risk of delivering a small-for-gestational-age or large-for-gestational-age infant by race, along with the implications of gaining weight according to the Institute of Medicine guidelines.

Methods: Logistic regression methods were used to identify risk factors for small- and large-for-gestational-age births among 2617 Black and 1253 White women delivering at the Johns Hopkins Hospital between 1987 and 1989.

Results: Rate of total weight gain was related to risk of small- and large-for-gestational-age births; the relationship differed according to maternal body mass index but not race. No differences in outcome by race were evident for women with low body mass indexes; among those with average or high indexes, however, Black women were at higher risk of small-for-gestational-age births and at lower risk of large-for-gestational-age births.

Conclusions: Having Black women gain at the upper end of the recommended range is unlikely to produce measurable reductions in small-for-gestational-age births. Some beneficial reductions in the risk of large-for-gestational-age births may occur if weight gain recommendations are lowered for average-weight and overweight White women.

MeSH terms

  • Adolescent
  • Adult
  • Baltimore
  • Black People*
  • Body Mass Index
  • Female
  • Fetal Growth Retardation / ethnology
  • Fetal Growth Retardation / prevention & control
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Male
  • Obstetric Labor Complications / ethnology
  • Obstetric Labor Complications / prevention & control*
  • Pregnancy
  • Pregnancy Complications / ethnology
  • Pregnancy Complications / prevention & control*
  • Pregnancy Outcome
  • Risk Factors
  • Weight Gain*
  • White People*