Sarah C Couch and Richard J Deckelbaum

Summary Obesity in pregnancy is associated with numerous maternal and neonatal complications including difficulty conceiving, increased risk of miscarriage, fetal anomalies and mortality, higher rates of gestational hypertension, gestational diabetes and preeclampsia, and an increased risk of cesarean section and delivery related complications. Nevertheless, more women are entering pregnancy with excessive weight and are gaining weight above the Institute of Medicine (IOM) recommendations during pregnancy. Weight loss is not recommended during pregnancy; however, overweight and obese women should be advised to aim for a moderate weight loss prior to conception and during the postpartum period. Strategies for achieving moderate progestational and postpartum weight loss include a low-calorie, low-fat diet and at least 45 min of daily physical activity. Benefits to mother and child are achieved with even a moderate weight loss. Importantly, health care professionals should counsel women on gaining an appropriate amount of weight during pregnancy. More research is needed on effective intervention approaches to promote optimal weight status before and after pregnancy and to support optimal weight gain during pregnancy.

Keywords: Obesity, Overweight, Pregnancy, Gestational weight gain, Maternal and neonatal complications, Weight management strategies

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