ABSTRACT OBJECTIVES This study aimed to assess and compare the Institute of Medicine (IOM) guidelines and the recently published China guidelines regarding their applicability for

gestational weight gain (GWG) management among Chinese pregnant women. METHOD Data were extracted from the Electronic Medical Record System of Zhoushan, China. Adverse outcomes include small

for gestational age (SGA), large for gestational age (LGA), low birth weight and macrosomia. GWG were estimated by the China and IOM GWG guidelines, respectively. Multiple logistical

regression models were used to analyze the associations of GWG with outcomes. The modified guidelines were developed. RESULTS Among 9975 pregnant women without comorbidities (i.e.,

had an increased risk of LGA (aOR = 1.49; 95% CI: 1.12, 1.98) and macrosomia (aOR = 1.70; 95% CI: 1.11, 2.60). Similar results weren’t observed among 4438 pregnant women with comorbidities.

The modified guidelines were developed by combining the weekly GWG targets from the IOM (bottom values) and the China guidelines (upper values). The modified guidelines with Chinese BMI

cut-off points exhibited the highest sensitivity for all adverse outcomes. CONCLUSION The China guidelines would better recognize pregnant women at risk of LGA and macrosomia but overlook a

subgroup of women at risk of SGA, as recognized by the IOM guidelines. These disparities emphasized neither guidelines may be entirely suitable for GWG management in China. The modified

guideline would be more appropriate for Chinese pregnant women, but further validation through research is needed. Access through your institution Buy or subscribe This is a preview of

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ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS ESTIMATED OPTIMAL GESTATIONAL

WEIGHT GAIN FOR PREGNANT WOMEN WITH GESTATIONAL DIABETES MELLITUS: A PROSPECTIVE COHORT STUDY IN CHINA Article 18 November 2022 EFFECTIVE GESTATIONAL WEIGHT GAIN ADVICE TO OPTIMIZE INFANT

BIRTH WEIGHT IN JAPAN BASED ON QUANTILE REGRESSION ANALYSIS Article Open access 28 November 2023 SEEKING THE OPTIMAL GESTATIONAL WEIGHT GAIN ACCORDING TO THE PRE-PREGNANCY BODY MASS INDEX: A

CROSS-SECTIONAL STUDY FROM SHANGHAI, CHINA Article 10 September 2024 DATA AVAILABILITY All datasets generated during and analyzed during the current study are not publicly available but are

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Google Scholar  Download references ACKNOWLEDGEMENTS We extend our deepest gratitude to all participants and their families and thank the medical staffs for their works. FUNDING The authors

acknowledge the financial support from the National Key Research and Development Programme of China (grant number 2021YFC2701901 and 2022YFC2703505); the 4+X Clinical Research Project of

Women’s Hospital, School of Medicine, Zhejiang University (ZDFY2021-4X104); Major research and development projects of Zhejiang science and Technology Department (grant number 2018C03010);

Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province (grant number 2020E10004); and Leading Innovative and Entrepreneur Team Introduction Pro-gram of Zhejiang (grant number

2019R01007). AUTHOR INFORMATION Author notes * These authors contributed equally: Lieping Huang, Ye Huang. AUTHORS AND AFFILIATIONS * Zhoushan Women and Children Hospital, Zhoushan, China

Lieping Huang * Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China Ye Huang, Peihan Chi, Yan

Zhuang, Xialidan Alifu, Haoyue Cheng, Haibo Zhou, Yiwen Qiu, Libi Zhang, Diliyaer Ainiwan, Zhicheng Peng & Yunxian Yu * Department of Epidemiology & Health Statistics, School of

Public Health, School of Medicine, Zhejiang University, Hangzhou, China Ye Huang, Peihan Chi, Yan Zhuang, Xialidan Alifu, Haoyue Cheng, Haibo Zhou, Yiwen Qiu, Libi Zhang, Diliyaer Ainiwan, 

Zhicheng Peng & Yunxian Yu * Yiwu Maternity and Children Hospital, Yiwu, 322000, China Shuting Si * Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China

Hui Liu * Department of Obstetrics, Women’s Hospital, Zhejiang University School of Medicine, Xueshi Rd #1, Hangzhou, 310006, China Danqing Chen Authors * Lieping Huang View author

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for this author inPubMed Google Scholar * Yunxian Yu View author publications You can also search for this author inPubMed Google Scholar CONTRIBUTIONS All authors have seen and approved

the final version of the manuscript. L.H., Y.H., and Y.Y. conceived the designed and study. P.C., Y.Z. and X.A. completed the data analyses. H.C. and H.Z. interpreted the results. P.C.,

H.C., Y.Q., L.Z. and D.A. took part in the study design and data collection. ZP, S.S., D.C. and H.L. took part in the study design and supervised field investigation. L.H and Y.H. drafted

the manuscript which revised by Y.Y. CORRESPONDING AUTHOR Correspondence to Yunxian Yu. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no competing interests. CONSENT TO PUBLISH

All of the authors have read and approved the publication of the paper. ETHICS APPROVAL AND CONSENT TO PARTICIPATE This study protocol was approved by the institutional review board of

Zhejiang University School of Medicine (No. 2011-1-002). This study conformed to the principles of the declaration of Helsinki. Informed consent was obtained from all subjects involved in

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and applicable law. Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Huang, L., Huang, Y., Chi, P. _et al._ The effects of China-recommended gestational weight gain guidelines

and the Institute of Medicine guidelines on adverse birth outcomes: A population- based cohort study. _Eur J Clin Nutr_ (2025). https://doi.org/10.1038/s41430-025-01576-3 Download citation *

Received: 19 October 2023 * Revised: 25 December 2024 * Accepted: 03 February 2025 * Published: 10 March 2025 * DOI: https://doi.org/10.1038/s41430-025-01576-3 SHARE THIS ARTICLE Anyone you

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