# Innovative approaches to inform evidence-based pregnancy weight gain guidelines

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2020 · $476,450

## Abstract

PROJECT SUMMARY / ABSTRACT
A large volume of research has shown that excessive pregnancy weight gain contributes to maternal
postpartum weight retention, child obesity, cesarean delivery, gestational diabetes and preeclampsia, while low
gestational weight gain is linked with fetal growth restriction, preterm birth, and perinatal death. However, major
gaps remain in our ability to convert these findings into evidence-based recommendations on optimal
pregnancy weight gain. The status quo is to evaluate each outcome separately, and without regard to its
perceived severity. Further, subjective approaches have been used to select the cut-points of recommended
weight gain ranges. Policy-makers urgently need evidence on the optimal range of pregnancy weight gain that
considers multiple adverse outcomes simultaneously, accounts for differences in the relative severity of
different outcomes, and establishes cut-points using systematic and reproducible methods.
In this application, we will develop and apply advanced methodologies that support the creation of robust,
evidence-based public health recommendations for weight gain in pregnancy. First, we will generate weights
reflecting stakeholder perspectives on the relative severity of competing maternal and child health outcomes
associated with gestational weight gain. A Delphi-consensus process will summarize the perceived severity of
competing maternal and child health outcomes from diverse panels of 60 women and 60 content experts.
Second, we will use a large, diverse cohort of U.S. pregnant women to determine the relationship between
gestational weight gain and a composite outcome of adverse events for mothers (preeclampsia, gestational
diabetes, cesarean delivery, longer-term obesity, subclinical cardiovascular disease) and children (perinatal
death, preterm birth, and small- and large-for-gestational-age birth), with each component weighted to account
for its relative severity. Then, we will use our previously-published quantitative approach to identify the optimal
range of pregnancy weight gain for women according to different body mass index values, defined as the
weight gain associated with the lowest risks of combined, severity-weighted maternal and child outcomes.
Successful completion of these aims will provide policy makers with evidence on the complex trade-offs
between low and high weight gain on short- and longer-term maternal and child health in order to inform
pregnancy weight gain guidelines. Our innovative approach to study multiple adverse outcomes simultaneously
and account for their relative severity will enable us to overcome challenges that have previously impeded the
synthesis of existing research studies into a systematic, evidence-based weight gain guideline. Our work will
impact public health and medical practice by providing high quality evidence for optimizing the nutritional care
of pregnant mothers and children.

## Key facts

- **NIH application ID:** 9959465
- **Project number:** 5R01HD094777-03
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Lisa M Bodnar
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $476,450
- **Award type:** 5
- **Project period:** 2018-09-19 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9959465

## Citation

> US National Institutes of Health, RePORTER application 9959465, Innovative approaches to inform evidence-based pregnancy weight gain guidelines (5R01HD094777-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9959465. Licensed CC0.

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