Gestational weight gain charts for different body mass index groups for women in Europe, North America, and Oceania

Susana Santos, Iris Eekhout, Ellis Voerman, Romy Gaillard, Henrique Barros, Marie-Aline Charles, Leda Chatzi, Cecile Chevrier, George P. Chrousos, Eva Corpeleijn, Nathalie Costet, Sarah Crozier, Myriam Doyon, Merete Eggesbo, Maria Pia Fantini, Sara Farchi, Francesco Forastiere, Luigi Gagliardi, Vagelis Georgiu, Keith M. GodfreyDavide Gori, Veit Grote, Wojciech Hanke, Irva Hertz-Picciotto, Barbara Heude, Marie-France Hivert, Daniel Hryhorczuk, Rae-Chi Huang, Hazel Inskip, Todd A. Jusko, Anne M. Karvonen, Berthold Koletzko, Leanne K. Kupers, Hanna Lagstrom, Debbie A. Lawlor, Irina Lehmann, Maria-Jose Lopez-Espinosa, Per Magnus, Renata Majewska, Johanna Makela, Yannis Manios, Sheila W. McDonald, Monique Mommers, Camilla S. Morgen, George Moschonis, Lubica Murinova, John Newnham, Ellen A. Nohr, Anne-Marie Nybo Andersen, Emily Oken, Adriette J. J. M. Oostvogels, Agnieszka Pac, Eleni Papadopoulou, Juha Pekkanen, Costanza Pizzi, Kinga Polanska, Daniela Porta, Lorenzo Richiardi, Sheryl L. Rifas-Shiman, Nel Roeleveld, Loreto Santa-Marina, Ana C. Santos, Henriette A. Smit, Thorkild I. A. Sorensen, Marie Standl, Maggie Stanislawski, Camilla Stoltenberg, Elisabeth Thiering, Carel Thijs, Maties Torrent, Suzanne C. Tough, Tomas Trnovec, Marleen M. H. J. van Gelder, Lenie van Rossem, Andrea von Berg, Martine Vrijheid, Tanja G. M. Vrijkotte, Oleksandr Zvinchuk, Stef van Buuren, Vincent W. V. Jaddoe*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


BackgroundGestational weight gain differs according to pre-pregnancy body mass index and is related to the risks of adverse maternal and child health outcomes. Gestational weight gain charts for women in different pre-pregnancy body mass index groups enable identification of women and offspring at risk for adverse health outcomes. We aimed to construct gestational weight gain reference charts for underweight, normal weight, overweight, and grades 1, 2 and 3 obese women and to compare these charts with those obtained in women with uncomplicated term pregnancies.MethodsWe used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America, and Oceania. Of these women, 9065 (4.2%), 148,697 (68.1%), 42,678 (19.6%), 13,084 (6.0%), 3597 (1.6%), and 1095 (0.5%) were underweight, normal weight, overweight, and grades 1, 2, and 3 obese women, respectively. A total of 138, 517 women from 26 cohorts had pregnancies with no hypertensive or diabetic disorders and with term deliveries of appropriate for gestational age at birth infants. Gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2, and 3 obese women were derived by the Box-Cox t method using the generalized additive model for location, scale, and shape.ResultsWe observed that gestational weight gain strongly differed per maternal pre-pregnancy body mass index group. The median (interquartile range) gestational weight gain at 40weeks was 14.2kg (11.4-17.4) for underweight women, 14.5kg (11.5-17.7) for normal weight women, 13.9kg (10.1-17.9) for overweight women, and 11.2kg (7.0-15.7), 8.7kg (4.3-13.4) and 6.3kg (1.9-11.1) for grades 1, 2, and 3 obese women, respectively. The rate of weight gain was lower in the first half than in the second half of pregnancy. No differences in the patterns of weight gain were observed between cohorts or countries. Similar weight gain patterns were observed in mothers without pregnancy complications.ConclusionsGestational weight gain patterns are strongly related to pre-pregnancy body mass index. The derived charts can be used to assess gestational weight gain in etiological research and as a monitoring tool for weight gain during pregnancy in clinical practice.

Original languageEnglish
Article number201
Number of pages15
JournalBMC Medicine
Publication statusPublished - 5 Nov 2018


  • Weight gain
  • Pregnancy
  • Charts
  • References
  • AGE
  • Humans
  • Pregnancy Complications
  • North America
  • Oceania
  • Adult
  • Female
  • Body Mass Index
  • Europe
  • Risk Factors
  • Pregnancy Outcome
  • Gestational Weight Gain/physiology


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