Context

Approximately 30% of pregnant women in developed countries are overweight or obese.1 Maternal obesity is a major risk factor for maternal and fetal complications, including maternal and fetal mortality, miscarriage, gestational diabetes mellitus, pregnancy-induced hypertensive disorders, infection, thromboembolic disease, induction of labour, macrosomia, caesarean section and stillbirth.2

In 2009, the Institute of Medicine revised its recommendations for weight gain in pregnancy advising that overweight and obese women should restrict gestational weight gain to 15–25 lb (6.8–11.3 kg) and …