Insufficient weight gain is associated with increased risks of preterm birth and delivering a low birth weight infant, whereas excessive weight gain is associated with increased risks of gestational hypertension, preterm birth, delivering a high birth weight infant, cesarean delivery, and childhood overweight. Gestational weight gain is an important predictor of adverse maternal and child health outcomes. The derived charts can be used to assess gestational weight gain in etiological research and as a monitoring tool for weight gain during pregnancy in clinical practice. Gestational weight gain patterns are strongly related to pre-pregnancy body mass index. Similar weight gain patterns were observed in mothers without pregnancy complications. No differences in the patterns of weight gain were observed between cohorts or countries. The rate of weight gain was lower in the first half than in the second half of pregnancy. We observed that gestational weight gain strongly differed per maternal pre-pregnancy body mass index group. Gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2, and 3 obese women were derived by the Box-Cox t method using the generalized additive model for location, scale, and shape. A total of 138, 517 women from 26 cohorts had pregnancies with no hypertensive or diabetic disorders and with term deliveries of appropriate for gestational age at birth infants. We used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America, and Oceania. We aimed to construct gestational weight gain reference charts for underweight, normal weight, overweight, and grades 1, 2 and 3 obese women and to compare these charts with those obtained in women with uncomplicated term pregnancies. Gestational weight gain charts for women in different pre-pregnancy body mass index groups enable identification of women and offspring at risk for adverse health outcomes. Gestational weight gain differs according to pre-pregnancy body mass index and is related to the risks of adverse maternal and child health outcomes. Gestational weight gain charts for different body mass index groups for women in Europe, North America, and OceaniaīMC Medicine volume 16, Article number: 201 ( 2018)
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