The aim of this study was to measure the adequacy of gestational weight gain (GWG) in Indian women using various behavioural interventions during pregnancy, which primarily aim to observe the effects on obesity markers and weight retention. In this experimental study, one hundred and forty pregnant women underwent interventions in 5 groups, control (C), diet (D), home exercise (HE), supervised exercise (SE) and supervised exercise with diet (SED), from pregnancy through delivery with 2 months follow-up post-delivery. The outcome measures were GWG and baby birth weight. A one-way ANOVA indicated no differences in the mean GWG between groups (12.39±4.71 kg, p=0.947). The control group had the most (50%) and both the supervised exercise groups had the fewest (32%) women who gained above the recommended GWG, followed by the diet group (33.3%). The D and HE groups had the most women who gained within the GWG range, while both the SE and SED groups had the most women who gained below the GWG range. However, these results did not affect the birth weight between the groups (mean 2.96 kg±0.40, p=0.203). In women with normal BMIs, (18.5-22.9 kg/m2), the diet group had the most effective maintenance of adequate GWG, with 15%, 55%, and 30% of the women gaining above, within, and below the recommended GWG, respectively. The SE and SED groups had the least postpartum weight retention (PPWR) at 2 months, followed by the HM, D and C groups; i.e., the results showed a trend in the desired direction clinically, although they were not statistically significant (p=0.12). Supervised exercise can be effectively used as a pregnancy intervention to prevent excess GWG in Indian women. Diet counselling was found to be the next best intervention in combination with exercise, as well as for women with normal BMI.
If the inline PDF is not rendering correctly, you can download the PDF file here.
1. Institute of Medicine and National Research Council Committee to Reexamine IOM Pregnancy Weight Guidelines. Composition and components of gestational weight gain: physiology and metabolism. In: Rasmussen KM Yaktine AL eds. In: Washington DC: National Academies Press 2009; 71-110.
2. Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines; Rasmussen KM Yaktine AL editors. Weight Gain during Pregnancy: Re-examining the Guidelines. Washington DC: National Academies Press (US); 2009.
3. Bhavadharini B Anjana RM Deepa M Jayashree G Nrutya S Shobana M et al. Gestational weight gain and pregnancy outcomes in relation to body mass index in Asian Indian women. Indian J Endocr Metab 2017; 21:588-93.
4. Deputy NP Sharma AJ Kim SY Hinkle SN. Prevalence and Characteristics Associated With Gestational Weight Gain Adequacy. Obstet Gynecol 2015; 125(4): 773-781. doi:
5. Papazian T Tayeh GA Sibai D Hout H Melki I Khabbaz LR. Impact of maternal body mass index and gestational weight gain on neonatal outcomes among healthy Middle- Eastern females. PLoS One 2017; 12(7): e0181255.
6. Mamun A. Excess gestational weight gain and its long term health impact - Public health burden and policy. Obesity research and clinical practice 2014; 8(1):62.
7. The LIFE-Moms Research Group. Design of Lifestyle Intervention Trials to Prevent Excessive Gestational Weight Gain in Women with Overweight or Obesity. Obesity (Silver Spring) 2016 ; 24(2): 305-313.
8. Rauh K Gunther J Kunath J Stecher L Hauner H. Lifestyle intervention to prevent excessive maternal weight gain: mother and infant follow-up at 12 months postpartum. BMC Pregnancy Childbirth 2015 ;15:265.
9. Haby K Glantz A Hanas R Premberg A. Mighty Mums - An antenatal health care intervention can reduce gestational weight gain in women with obesity. Midwifery 2015 ;31(7):685-92.
10. Josefson JL Hoffmann JA Metzger BE. Excessive weight gain in women with a normal pre-pregnancy BMI is associated with increased neonatal adiposity. Pediatr Obes 2013; 8(2): e33-e36.
11. Pawalia A Kulandaivelan S Savant S Yadav VS. Behavioral Intervention during Pregnancy for Preventing Abdominal Obesity and Pregnancy Complications in Indian Women: Study Protocol Indian J of Public Health Research & Development 2018; 9(3): 11-15. DOI Number: 10.5958/0976-5506.2018.00174.2.
12. Brekke HK Bertz F Rasmussen KM Bosaeus I Ellegard L Winkvist A (2014) Diet and Exercise Interventions among Overweight and Obese Lactating Women: Randomized Trial of Effects on Cardiovascular Risk Factors. PLoS ONE 9(2): e88250.
13. Hui AL Back L Ludwig S Gardiner P Sevenhuysen G Dean HJ et al Effects of lifestyle intervention on dietary intake physical activity level and gestational weight gain in pregnant women with different prepregnancy Body Mass Index in a randomized control trial. BMC Pregnancy Childbirth. 2014; 24(14):331. doi:
13. Hui AL, Back L, Ludwig S, Gardiner P, Sevenhuysen G, Dean HJ et al, Effects of lifestyle intervention on dietary intake, physical activity level, and gestational weight gain in pregnant women with different prepregnancy Body Mass Index in a randomized control trial. BMC Pregnancy Childbirth. 2014; 24(14):331. doi: 10.1186/1471-2393-14-331.)| false
14. Jiang H Qian X Li M Lynn H Fan Y Jiang H et al. Can physical activity reduce excessive gestational weight gain? Findings from a Chinese urban pregnant women cohort study. Int J Behav Nutr Phys Act 2012; 9: 12.
15. Muktabhant B Lawrie TA Lumbiganon P Laopaiboon M. Diet or exercise or both for preventing excessive weight gain in pregnancy. Cochrane Database Syst Rev 2015 15;(6):CD007145.
16. Sagedal LR Overby NC Bere E Torstveit MK Lohne- Seiler H Smastuen M et al. Lifestyle intervention to limit gestational weight gain: The Norwegian Fit for Delivery randomised controlled trial. BJOG 2017;124:97-109.
17. Hui A Back L Ludwig S Gardiner P Sevenhuysen G Dean H et al. Lifestyle intervention on diet and exercise reduced excessive gestational weight gain in pregnant women under a randomised controlled trial. BJOG 2012;119: 70-77.
18. “Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials The International Weight Management in Pregnancy (i-WIP) Collaborative Group” BMJ 2017;358:j3119 doi:
18. “Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials The International Weight Management in Pregnancy (i-WIP) Collaborative Group,” BMJ 2017;358:j3119 doi: 10.1136/bmj.j3119.)| false
19. Aşcı O and Rathfisch G. Effect of lifestyle interventions of pregnant women on their dietary habits lifestyle behaviors and weight gain: a randomized controlled trial. J Health Popul Nutr 2016; 35: 7.
20. Nicodemus NA. Prevention of excessive Gestational Weight Gain and Postpartum Weight Retention. Curr Obes Rep 2018; 1-7. https://doi.org/10.1007/s13679-018-0312-0
21. Yang YD Yang HX. Investigation into the clinical suitability of Institute of Medicine 2009 guidelines regarding weight gain during pregnancy for women with full term singleton fetus in China. Zhonghua Fu Chan Ke Za Zhi 2012;47:646-50.
22. Liu Y Dai W Dai X Li Z. Prepregnancy body mass index and gestational weight gain with the outcome of pregnancy: A 13-year study of 292568 cases in China. Arch Gynecol Obstet 2012; 286:905-11.
23. Ota E Haruna M Suzuki M Anh DD Tho le H Tam NT et al. Maternal body mass index and gestational weight gain and their association with perinatal outcomes in Viet Nam. Bull World Health Organ 2011; 89:127-36.
24. Wong W Tang NL Lau TK Wong TW. A new recommendation for maternal weight gain in Chinese women. J Am Diet Assoc 2000; 100:791-6.
25. Ronnberg AK Nilsson K. Interventions during pregnancy to reduce excessive gestational weight gain: a systematic review assessing current clinical evidence using the Grading of Recommendations Assessment Development and Evaluation (GRADE) system. BJOG 2010; 117(11):1327-1334.
26. Luo XD Dong X Zhou J. Effects of nutritional management intervention on gestational weight gain and perinatal outcome. Saudi Med J 2014; 35(10): 1267-1270.
27. Lamminpaa R Vehvilainen-Julkunen K Schwab U. A systematic review of dietary interventions for gestational weight gain and gestational diabetes in overweight and obese pregnant women. Eur J Nutr 2017; 1-16.
28. Brekke HK Bertz F Rasmussen KM Bosaeus I Ellegard L Winkvist A. Diet and Exercise Interventions among Overweight and Obese Lactating Women: Randomized Trial of Effects on Cardiovascular Risk Factors. PLoS ONE 2014; 9(2): e88250.
29. Oken E Taveras EM Kleinman KP Rich-Edwards JW Gillman MW. Gestational weight gain and child adiposity at age 3 years. Am J Obstet Gynecol 2007;196:322.e1-8.
30. Stevens-Simon C Roghmann KJ McAnarney ER. Relationship of self-reported prepregnant weight and weight gain during pregnancy to maternal body habitus and age. J Am Diet Assoc 1992;92: 85-7.
31. Yu SM Nagey DA. Validity of self-reported pregravid weight. Ann Epidemiol 1992;2: 715-21.