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Expert Rev Endocrinol Metab. 2015;10(2):227-242. Epub 2014 Dec 16.

Optimizing Weight for Maternal and Infant Health - Tenable, or Too Late?

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Division of General Internal Medicine, University of Colorado School of Medicine, 12348 E. Montview Blvd, C263, Aurora, CO 80045, 303-724-9028 (work phone), 617-510-7273 (cell phone), 303-724-9976 (fax).
Professor of Medicine and Obstetrics and Gynecology, Divisions of Endocrinology, Metabolism, and Diabetes and Maternal-Fetal Medicine, University of Colorado School of Medicine, Mail Stop 8106, 12801 E. 17 Avenue, Aurora, CO 80045, 303-724-3921 (work phone), 303-594-0474 (cell phone), 303-724-3920 (fax).


Obesity in pregnancy is the leading cause of maternal and fetal morbidity, and gestational weight gain (GWG) is one modifiable risk factor that improves pregnancy outcomes. Most pregnant women gain more than the 2009 Institute of Medicine recommendations, particularly overweight and obese women. GWG even less than the 2009 IOM guidelines in obese women may improve pregnancy outcomes and reduce large-for-gestational-age (LGA) infants, an independent risk factor for childhood obesity, without increasing small-for-gestational-age (SGA) infants. Unfortunately, despite the fact that over 50 interventional trials designed to decrease excess GWG have been conducted, these interventions have been only modestly effective, and interventions designed to facilitate weight postpartum weight loss have also been disappointing. Successful interventions are of paramount importance not only to improve pregnancy outcomes but also for the future metabolic health of the mother and her infant, and may be key in attenuating the trans-generational risk on childhood obesity.


Institute of Medicine guidelines; Obesity; childhood obesity; diet; fetal programming; gestational weight gain; interventions; large for gestational age infants; physical activity; postpartum weight loss; pregnancy; pregnancy outcomes

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