Behavioral Interventions for Healthy Weight Gain During Pregnancy | Guidelines | JAMA | JAMA Network
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JAMA Patient Page
May 25, 2021

Behavioral Interventions for Healthy Weight Gain During Pregnancy

Author Affiliations
  • 1Associate Editor, JAMA
JAMA. 2021;325(20):2126. doi:10.1001/jama.2021.7530

The US Preventive Services Task Force (USPSTF) recently published recommendations on behavioral interventions to promote a healthy amount of weight gain during pregnancy.

Weight and Pregnancy

It is normal and expected to gain weight during pregnancy (gestational weight gain). How much weight should be gained depends on what a person’s starting weight is before pregnancy. For people who are underweight, the recommended amount of weight gain during pregnancy is 28 to 40 pounds. For people at normal weight, the recommended weight gain is 25 to 35 pounds. For people who are overweight or obese, the recommended weight gain is 11 to 20 pounds.

In 2015, nearly half of pregnant people in the US began their pregnancy overweight or obese. Starting pregnancy at too high a weight, or gaining too much weight during pregnancy, can lead to maternal and infant health problems including gestational diabetes (diabetes during pregnancy), high birth weight, preterm birth, and increased chance of unplanned cesarean (surgical) delivery.

How Can Behavioral Interventions Promote Healthy Weight Gain During Pregnancy?

Behavioral interventions are focused on promoting healthy eating and physical activity through counseling and/or supervised exercise. These interventions can be provided by prenatal care clinicians including midwives, family medicine physicians, and obstetricians; health educators; physical therapists; fitness specialists; or clinical and registered dietitians. Interventions generally start during the first trimester or beginning of the second trimester and end before delivery. Counseling sessions can be done face to face, by phone, or online.

What Is the Population Under Consideration?

This recommendation applies to pregnant adolescents and adults in primary care settings (including prenatal care settings such as obstetrics/gynecology, family medicine, and midwifery clinics).

What Are the Potential Benefits and Harms of Promoting Healthy Weight Gain During Pregnancy?

Behavioral interventions during pregnancy are associated with less gestational weight gain and a lower chance of exceeding recommendations for normal gestational weight gain. Behavioral interventions are also associated with a decreased risk of gestational diabetes, emergency cesarean delivery, high birth weight and infants who are large for their gestational age, and reduced postpartum weight retention at 1 year. Potential harms of behavioral interventions are minimal, if any.

How Strong Is the Recommendation to Promote Healthy Weight Gain During Pregnancy?

The USPSTF concludes with moderate certainty that effective behavioral counseling interventions aimed at promoting healthy weight gain and preventing excess weight gain during pregnancy have a moderate net benefit for pregnant persons.

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Article Information

Conflict of Interest Disclosures: None reported.

Source: US Preventive Services Task Force. Behavioral counseling interventions for healthy weight and weight gain in pregnancy: US Preventive Services Task Force recommendation statement. JAMA. Published May 25, 2021. doi:10.1001/jama.2021.7530

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