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The effects of high or low gestational weight gain differ depending on maternal BMI and the outcome variable studied. Obese women may benefit from a low weight gain during pregnancy.

Objective To minimise obese women's total weight gain during pregnancy to less than 7 kg and to investigate the delivery and neonatal outcome.Design A prospective case-control intervention study.Setting Antenatal care clinics in the southeast region of Sweden.Population One hundred fifty-five pregnant women in an index group and one hundred ninety-three women in a control group.Methods An intervention programme with weekly motivational talks and aqua aerobic classes for obese pregnant women.Main outcome measures Weight gain in kilograms, delivery and neonatal outcome. ResultsThe index group had a significantly lower weight gain during pregnancy compared with the control group (P < 0.001). The women in the index group weighed less at the postnatal check-up compared with the weight registered in early pregnancy (P < 0.001). The percentage of women in the index group who gained less than 7 kg was greater than that of women in the control group who gained less than 7 kg (P = 0.003). The percentage of nulliparous women in this group was greater than that in the control group (P = 0.018). In addition, the women in the index group had a significantly lower body mass index at the postnatal check-up, compared with the control group (P < 0.001). There were no differences between the index group and the control group regarding birthweight, gestational age and mode of delivery. ConclusionThe intervention programme was effective in controlling weight gain during pregnancy and did not affect delivery or neonatal outcome.