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Gestational Weight Gain

Ensuring proper nutrition, adequate physical activity and healthy weight status are important before, during and after pregnancy to promote healthy growth and development in infants. Healthcare providers play an important role in supporting a healthy pregnancy for their patients.

 

Preconception and Weight

A woman’s weight status should be assessed prior to pregnancy to determine her body mass index (BMI). Her pre-conception BMI is used to determine proper weight gain goals during pregnancy.1 Women should be encouraged and supported to attain and maintain a pre-pregnancy BMI within the normal range to promote better health and decreased risk of disease in both herself and her infant.1

Women with a high BMI (>25) are at increased risk of poor health and poor pregnancy outcomes, such as increased risk of gestational diabetes, preeclampsia, labour complications and excess postpartum weight retention.2Their infants are at risk of fetal overgrowth (large-for-gestational-age infant), fetal distress, and childhood obesity.2 Women with a low BMI (<18.5) are also at increased risk of complications, including risk of pre-term delivery and birth of a small-for-gestational-age infant.2

Weight Gain during Pregnancy

Weight gain during pregnancy is used as a marker of health of the mother and the developing fetus. Weight gain goals are set based on a woman’s pre-pregnancy BMI and whether it is a multiple pregnancy.1 Weight gain can also be affected by factors, such as genetic characteristics, underlying health concerns, socioeconomic status and attitude towards weight gain.1 Generally, a woman will gain approximately 1 to 2 kg in the first trimester.1 Women who gain more or less should be assessed as they may be at risk of complications.1

The charts below list weight gain goals.

 

 

Singleton Pregnancy1

Pre-Pregnancy BMI

Mean rate of weight gain in 2nd and 3rd trimesters

Recommended Total Weight Gain

kg/week

lb/week

kg

lbs

<18.5

0.5

1.0

12.5-18

28-40

18.5-24.9

0.4

1.0

11.5-16

25-35

25-29.9

0.3

0.6

7-11.5

15-25

>30

0.2

0.5

5-9

11-20

>35

Lower weight gain recommendations may be suggested based on clinical evaluation and assessment of risks to mother and infant

 Twin Pregnancy1

Pre-Pregnancy BMI

Recommended Total Weight Gain

kg

lbs

<18.5

Insufficient data to develop guidelines

18.5-24.9

17-25

37-54

25-29.9

14-23

31-50

>30

11-19

25-42

A woman who gains more weight than recommended is at increased risk of complications, such as birth of large-for-gestational-age infants, labour complications, excess postpartum retention of weight, gestational diabetes and increased risk of perinatal mortality.1 Their infants may also be at increased risk of being overweight/obese and developing type two diabetes.1

A woman who gains less weight than recommended is at increased risk of complications, such as preterm labour, birth of a small-for-gestational-age infant and birth of a low birth-weight infant.1 These infants are at increased risk of neonatal morbidity and mortality, physical and cognitive disabilities and chronic health problems later in life.1

Healthcare providers should regularly track a woman’s weight during pregnancy. Any variations outside of the recommended rates of weight gain should be discussed and the healthcare provider should provide support and resources to help promote optimal weight gain. A referral to a Registered Dietitian is recommended for women with a high or low pre-pregnancy BMI and women who gain too little or too much weight during pregnancy.

Eating Well and Being Active During Pregnancy

Healthcare providers should review and encourage healthy eating and activity, adequate sleep and lifestyle choices that foster good mental health during pregnancy to promote optimal weight gain. A healthy pregnancy has long-term health benefits for both the mother and infant.

  • Women only need 2-3 additional servings from Canada’s Food Guide during the second and third trimesters. Many women “eat for two” which may promote excessive weight gain.
  • Women should focus on the nutritional quality of their diet. Encourage women to eat vegetables, fruit, whole grains, meat alternatives (like beans, peas, lentils, nuts and seeds), low fat milk, fish, lean meats, and unsaturated oils. Processed foods and sugar-sweetened food and beverages should be limited.
  • Physical activity is an important component of a healthy pregnancy. Healthcare providers should encourage women to be physically active on most days throughout their pregnancy. Healthcare providers should discuss safe ways for a woman to be active during pregnancy.
  • Women who are nutritionally at risk should be referred to a Registered Dietitian for ongoing education and support throughout their pregnancy and postnatally.
 
Date of creation: December 22, 2017
Last modified on: October 3, 2018

References

1Health Canada. (2014, December 29). Prenatal Nutrition Guidelines for Health Professionals: Gestational Weight Gain. Retrieved from
https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/prenatal-nutrition/eating-well-being-active-towards-healthy-weight-gain-pregnancy-2010.html
2Best Start Resource Centre. (2013). Obesity in Preconception and Pregnancy. Retrieved from
https://www.beststart.org/resources/preconception/BSRC_obesity_report_April2014.pdf