Determinants of gestational weight gain outside the recommended ranges among black and white women

Objectives: To identify factors influencing risk of gaining outside the Institute of Medicine recommendations for pregnancy weight gain, and to determine whether these factors differ by race. Methods: Multivariate methods were used to identify risk factors for under- and over-gain among 2617 black and 1253 white women delivering at the Johns Hopkins Hospital during 1987-1989. Results: Only 28.2% of black women and 32.5% of white women gained the recommended amounts of weight during pregnancy. Maternal pre-pregnancy body mass index (BMI), height, parity, education, smoking, hypertension, duration of pregnancy, and fetal sex influenced risk for under-gain or over-gain. Black women were 1.51 (95% confidence interval [Cl] 1.23-1.85) times more likely to under-gain, but 0.89 (95% Cl 0.74-1.08) times less likely to over-gain than white women. No interactions were found between any factor examined and BMI or race. Conclusion: Only about one-third of women are gaining the recommended amounts of weight during pregnancy. Black women are at increased risk for gaining less weight than recommended, and selected maternal characteristics associated with race do not explain this difference. Further, risk factors for under- or over-gain do not differ between black and white women. (Obstet Gynecol 1996;87:760-6).