Body Weight Gain During Pregnancy: An Narrative Review

ABSTRACT Introduction: Maternal body mass index (BMI) and gestational weight gain (GWG) are strongly associated with obstetric and neonatal outcomes. Inadequate values of these parameters may result in complications such as macrosomia, cesarean delivery, gestational hypertension, preeclampsia, and gestational Diabetes mellitus (GDM), as well as negatively affecting offspring health. Objective: To evaluate the influence of pre-pregnancy BMI and weight gain during pregnancy trimesters on perinatal outcomes, including maternal and neonatal morbidities, based on different diagnostic criteria and clinical contexts. Method: This narrative review analyzed the impacts of excessive and insufficient maternal weight gain on maternal-fetal health. A PubMed database search yielded 507 articles between July 5–10, 2025. After a rigorous selection process, 14 studies were included, highlighting risks associated with gestational weight imbalance. Data synthesis: Studies indicated that both elevated BMI and excessive GWG significantly increased risks for adverse outcomes such as macrosomia and gestational hypertension. Conversely, inadequate GWG was associated with small-for-gestational-age newborns and preterm birth. Women who quit smoking during pregnancy had higher rates of GWG and hypertensive disorders. Structured physical activity interventions proved effective in mitigating excessive GWG. Additionally, GWG influenced adiposity and cardiometabolic markers in children. Conclusion: Pre-pregnancy BMI and weight gain throughout gestation directly impact maternal and neonatal health. Monitoring strategies, nutritional interventions, and physical activity should be prioritized to ensure appropriate GWG and improve obstetric and pediatric outcomes.