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Does Excessive Weight Gain During Pregnancy Increase Your Risk of Death?

Study reveals a link between unhealthy weight gain during pregnancy and increased risk of death 50 years later!

Study Highlights!

  1. High pregnancy weight gain is related to greater postpartum weight retention. This study sought to determine whether gestational weight change had any link with an increased risk of death after 50 years or not.
  2. The study found that unhealthy weight gain during pregnancy (above the recommended cut-off) was associated with an increased risk of death due to cardiovascular causes and all-cause mortality in women with a normal pre-pregnancy BMI.
  3. Weight gain during pregnancy is an indicator of fetal growth. However, weight gain above the normal limits during pregnancy can lead to obesity after pregnancy. This extra weight gain correlates with an increased risk of death due to diabetes and heart disease.

Weight gain during pregnancy:

Pregnant women tend to gain weight during pregnancy. Weight gain above the recommended cut-off may have negative short-term and long-term effects.

The American College of Obstetricians and Gynecologists has set out a list of recommendations for pregnant women based on their pre-pregnancy weight [Ref].

The IOM (Institute of Medicine) recommends a maximum weight gain of 5 to 11 kgs in overweight and obese pregnant women in their 2nd and 3rd trimesters as given in the table below [Ref].:

BMI CategoryBMI RangeRecommended Weight Gain (Pregnancy Weight Gain Chart in the 2nd and 3rd trimesters)
Underweight<18.512.7 – 18.14 kg (28 – 40 lbs)
Normal Weight18.5 – 24.911.3 – 15.8 kg (25 – 35 lbs)
Overweight Women25-29.96.8–11.3 kg (15–25 lb)
Obese Women30 or greater5–9.1 kg (11–20 lb)

the recommended weight gain per week during the first trimester is 1.1 to 4.4 lbs. However, weight gain is more prominent during the second and third trimesters because the fetus grows during this period.

The recommended weight gain per week during the 2nd and 3rd trimesters of pregnancy is as follows [Ref].:


BMI Range

Recommended Weight Gain per week in the 2nd and 3rd trimester

Underweight<18.51 lb (1 – 1.3 lbs)/ per week
Normal Weight18.5 – 24.91 (0.8 – 1 lbs)/ per week
Overweight Women25-29.90.6 (0.5 – 0.7 lbs)/ per week
Obese Women30 or greater0.5 (0.4 – 0.6 lbs)/ per week

Weight gain exceeding the recommended limits may be linked with complications in the mother and fetus.

Maternal complications may include:

Fetal complications of excessive maternal weight gain during pregnancy include:

  • Macrosomia which can then lead to birth trauma, shoulder dystocia, and neonatal respiratory distress syndrome
  • Preterm birth of the baby
  • Hypoglycemia, and 
  • Obesity in the child

Study Links Excessive Weight Gain During Pregnancy With an Increased Risk of Death!

A study published last week in The Lancet associated the increase in weight gain during pregnancy with higher chances of mortality, diabetes, and CVD [Ref].

Despite their weight status prior to pregnancy, extra weight gain was correlated with a higher risk of death.

This study was conducted by experts from the Perelman School of Medicine at the University of Pennsylvania, aiming to educate individuals about the health dangers associated with gaining unhealthy weight during pregnancy.

This study is not the first one to talk about this, as research from 2017 investigated a large body of pregnant women as well.

They concluded that weight gain, greater or lesser than recommendations, leads to adverse maternal and infant outcomes [Ref].

This new study is helpful in emphasizing the importance of maintaining a proper weight during pregnancy.


Study settings and analysis:

The primary focus of this study was to assess the link between gestational weight gain and mortality risks.

Researchers used data from a large study based in the USA, the Collaborative Perinatal Project (CPP), from 1959 to 1965.

Subjects from this cohort study were linked to the National Death Index and Social Security Death Master File to determine their vital status up to 2016.

This tells a lot about the magnitude of the research, with a remarkable follow-up period of 52 years. It investigated how weight changes during pregnancy affect long-term health.

By following 2009 guidelines for healthy weight gain during pregnancy and considering pre-pregnancy weight, researchers aimed to understand their impact on life expectancy and causes of death, such as heart issues or diabetes.

Subjects who started with some extra weight and gained too much faced even higher risks.

Conversely, moms with a normal pre-pregnancy weight who gained less than recommended had lower chances of diabetes-related issues later in life.

The association of excessive weight gain during pregnancy, above the recommended weight, was linked to an increased risk of death as summarized in the table below [Ref]:

Pre-Pregnancy BMI

Cardiovascular Mortality

All-Cause Mortality

Diabetes-Related Mortality

Underweight (<18.5 kg/m2)NoNo
Normal (18.5–24.9 kg/m2)No
Overweight (25.0–29.9 kg/m2)No

These findings contribute to our understanding of the significance of healthy weight management during pregnancy for women’s overall health in the decades that follow.


What causes this weight gain during pregnancy?

There is no denying the value that healthy pounds hold during pregnancy for a normal delivery [Ref].

Certain factors like access to food, adequate prenatal care, and social support contribute to sufficient weight gain, which is nourishing for both the mother and the baby [Ref].

The role of psychological support and family involvement is vital to a healthy weight gain as well [Ref].

Stress and depression lead to an array of disorders that can be fatal during pregnancy. So, a healthy weight can dictate the course of pregnancy.

On the other side, unhealthy weight gain during pregnancy comes from the lack of physical activity, which is due to concerns about possible miscarriage, damage to the baby, or other accidents [Ref].

Mental health issues and symptoms of stress and depression have hazardous impacts on weight gain [Ref], which calls for proper and immediate treatment.

A previous study has also stressed the importance of discussing healthy practices during prenatal visits [Ref].


What are the complications linked with unhealthy weight gain during pregnancy?

Status of weight gain during pregnancy is an important determinant of the overall health of a mother.

Research has continuously explored the link between pregnancy and chronic issues and emphasized the importance of screening for diseases during this course. [Ref]

Mother’s well-being is also compromised by such fluctuations, as proven by research that women who weighed above 95kg at 24-32 weeks of gestation were at advanced risk for insulin resistance and gestational diabetes mellitus [Ref].

Not just the mother but the baby faces severe complications from birth in this case. Maternal obesity and GDM (gestational diabetes) both lead to fetal overgrowth and childhood obesity or hypertension [Ref].

Gestational hypertension is another condition associated with modifiable factors like obesity before pregnancy, excessive gestational weight gain, and increased calorie intake while pregnant [Ref].

Maternal Complications of Excessive Weight Gain During Pregnancy

Fetal Complications of Excessive Weight Gain During Pregnancy

  • Macrosomia which can then lead to birth trauma, shoulder dystocia, and neonatal respiratory distress syndrome
  • Preterm birth of the baby
  • Hypoglycemia, and 
  • Obesity in the child

How to maintain weight during pregnancy

Since the new study has concluded that gestational weight gain is related to long-term health hazards, it is crucial for mothers to gain only the recommended weight.

Conducting a thorough analysis of your weight and consulting with your physician before, during, and after pregnancy can help you gain all the necessary info about healthy practices. [Ref]

Knowing your caloric needs will help big time with weight maintenance. According to the CDC, track your weight gain journey and ensure you eat a balanced diet full of whole foods, fruits, vegetables, and lean protein.

The first trimester does not demand extra calories, but 340 Kcal/day in the second trimester and 450 Kcal/day in the third is important [Ref].


What do you think?

Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

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