title: Factors Associated With Excessive Gestational Weight Gain: Review of Current Literature.
abstract: BACKGROUND
  Excessive gestational weight gain (EGWG) places women at increased risk for complications during pregnancy and also increases the likelihood that they will remain overweight after pregnancy. The Institute of Medicine (IOM) has recommended weight gain guidelines based on pre-pregnancy body mass index (BMI), but evidence-based strategies to achieve these goals are limited.
  
  
  OBJECTIVE
  This review discusses factors associated with EGWG with the goal of identifying targets for future intervention.
  
  
  METHODS
  A search was performed using the PubMed database to identify all English-language papers published between 1995 and 2014 related to excessive weight gain in pregnancy. Papers were grouped by theme: preconception BMI, sociodemographics, diet and exercise, psychosocial characteristics, and type of prenatal care.
  
  
  RESULTS
  Studies found that women who were overweight or obese at the time of conception were at higher risk of EGWG and that increased physical activity protected against EGWG. Studies on diet and sociodemographic characteristics were inconclusive. Psychological factors, specifically accurate perceptions of BMI, also appear to play a role in EGWG. Limited studies on methods of prenatal care delivery did not show improvement of weight parameters with group compared to one-on-one visits.
  
  
  CONCLUSIONS
  Pre-pregnancy BMI is most strongly associated with EGWG, indicating that healthy weight habits throughout adult life may be especially important in periods of expected weight change, such as pregnancy. To decrease EGWG, providers should focus on improving pre-conception BMI through appropriate counseling on healthy eating and increased physical activity as well as encouraging pregnant women to continue moderate exercise during pregnancy when appropriate.
authors.affiliation: Department of Obstetrics and Gynecology, Boston Medical Center, Massachusetts, United States.
authors.forename: Tirah
authors.initials: T
authors.lastname: Samura
authors.affiliation: Department of Obstetrics and Gynecology, Boston Medical Center, Massachusetts, United States.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Steer
authors.affiliation: Department of Obstetrics and Gynecology, Boston Medical Center, Massachusetts, United States.
authors.forename: L Daniela
authors.initials: LD
authors.lastname: Michelis
authors.affiliation: Department of Obstetrics and Gynecology, Boston Medical Center, Massachusetts, United States.
authors.forename: Lisa
authors.initials: L
authors.lastname: Carroll
authors.affiliation: Department of Obstetrics and Gynecology, Boston Medical Center, Massachusetts, United States.
authors.forename: Erica
authors.initials: E
authors.lastname: Holland
authors.affiliation: Department of Obstetrics and Gynecology, Boston Medical Center, Massachusetts, United States.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Perkins
keywords: BMI; Gestational weight gain; pregnancy; review