Guidelines on how to monitor gestational weight gain during antenatal care

Abstract

Gestational weight gain (GWG) should be tracked at all antenatal consultations, and pregnant women should gain weight according to pre-established guidelines. The recommendation on weight gain varies according to the pre-pregnancy nutritional status (body mass index -BMI).• Pre-pregnancy weight can be obtained from medical records, reported by the pregnant woman, or measured at the beginning of pregnancy. Maternal height should be obtained at the beginning of pregnancy. The two measures are used to calculate the pre-pregnancy BMI and classify the nutritional status as underweight, normal weight/eutrophic, overweight or obesity. • Until 2022, there was no weight gain curve for the Brazilian population and the Ministry of Health recommended the adoption of two tools for nutritional monitoring during pregnancy: Atalah's gestational BMI curve (Chile) and GWG recommendations from the Institute of Medicine -IOM (United States). • Based on data from 7,086 women participating in 21 studies that are part of the Brazilian Maternal and Child Nutrition Consortium (Portuguese acronym: CONMAI), specific GWG curves and recommendations were created for Brazilian pregnant women. • The new GWG curves and recommendations were discussed and endorsed by specialists in a workshop held in Brasília in June 2020, and adopted by the Ministry of Health as of 3 August, 2022. • The new system includes a single instrument that allows tracking and making recommendations on gestational weight gain. Recommendations• In antenatal care, guidelines on optimal weight gain should be based on the new GWG recommendations for Brazilian pregnant women. • Insufficient or excessive weight gain is associated with the occurrence of adverse maternal and neonatal outcomes. • The use of specific weight gain curves for Brazilian women presented in this document is the current recommendation of national guidelines. • Ranges of GWG according to pre-pregnancy BMI can also be used and should include the different guidelines for cumulative weight gain per trimester of pregnancy. • Gestational weight gain is a modifiable factor, so it must be carefully tracked in order to reduce risks associated with weight gain out of the range.