Objective: To evaluate whether advice on pregnancy weight gain from health care professionals, women's target weight gain (how much weight women thought they should gain), and actual weight gain corresponded with the 1990 Institute of Medicine recommendations. Methods: Predominantly white, middle- class women participating in a mail panel reported their prepregnancy weights, heights, and advised and target weight gains on a prenatal questionnaire (n = 2237), and their actual weight gains on a neonatal questionnaire (n = 1661). Recommended weight gains were categorized for women with low body mass index (BMI) (less than 19.8 kg/m2) as 25-39 lb; for women with average BMI (19.8-26.0 kg/m2) as 25-34 lb; and for women with high BMI (more than 26.0-29.0 kg/m2) and very high BMI (more than 29.0 kg/m2) as 15- 24 lb. Results: Twenty-seven percent of the women reported that they had received no medical advice about pregnancy weight gain. Among those who received advice, 14% (95% confidence interval [CI] 12%, 16%) had been advised to gain less than the recommended range and 22% (95% CI 20%, 24%) had been advised to gain more than recommended. The odds of being advised to gain more than recommended were higher among women with high BMIs and with very high BMIs compared with women with average BMIs. Black women were more likely than white women to report advice to gain less than recommended. Advised and target weight gains were associated strongly with actual weight gain. Receiving no advice was associated with weight gain outside the recommendations. Conclusion: Greater efforts are required to improve medical advice about weight gain during pregnancy.
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