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A new study of more than 1 million births led by McMaster University researchers has found that gaining too much weight during pregnancy, regardless of a person's starting weight, is linked to a higher risk of life-threatening maternal complications.

Current pregnancy weight-gain recommendations were developed primarily to improve outcomes for babies, such as healthy birth weight and reducing the risk of preterm birth. The study, published in JAMA Network Open, suggests the recommendations should also be evaluated through the lens of maternal health, including the risk of life-threatening complications such as bleeding, preeclampsia and ICU admission during childbirth.

"We've long known that a person's weight before pregnancy is a risk factor. We wanted to know whether the amount of weight gained during pregnancy also influences the risk of complications," says lead author Sahar Khademioore, a Health Research Methodology Ph.D. candidate at McMaster.

"Because weight gain is something that can potentially be addressed, understanding how it relates to severe complications gives us an opportunity to better support maternal health."

Of the more than 1 million Ontario pregnancies studied using the BORN Ontario birth registry:

People with pre-existing conditions such as diabetes, asthma and high blood pressure faced roughly double the risk of severe maternal complications, with risks increasing further when weight gain fell outside the recommended range. Researchers also found that gaining less than the recommended amount of weight was associated with higher risks of severe maternal outcomes in some BMI groups.

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