This review examines published literature to answer 2 questions: 1) Are there racial-ethnic differences in excessive or inadequate gestational weight gain (GWG) and postpartum weight retention (PPWR)? and 2) Is there evidence that approaches to promote healthy weight during and after pregnancy should vary by race-ethnicity? We identified a limited number of articles that explicitly looked at racial-ethnic differences in either GWG or PPWR after controlling for relevant covariates. These studies suggest that black and Hispanic women are more likely to gain inadequately based on the Institute of Medicine's pregnancy weight gain guidelines compared to white women. Black women are more likely to retain considerable amounts of weight postpartum compared to both Hispanic and white mothers. Studies were inconclusive as to whether Hispanic women retained more or less weight postpartum, so more research is needed. Interventions to increase GWG were few and those designed to reduce GWG and PPWR showed mixed results. Future studies should address the methodological and conceptual limitations of prior research as well as investigate biological mechanisms and behavioral risk factors to determine the reasons for the racial-ethnic differences in pregnancy-related weight outcomes. Interventions would benefit from a mixed-methods approach that specifically identifies race-relevant barriers to weight management during and after pregnancy. Attention to the greater social context in which pregnancy-related weight exists is also needed.

Growing evidence suggests that maternal prepregnancy weight and gestational weight gain are risk factors for perinatal complications and subsequent maternal and child health. Postpartum weight retention is also associated with adverse birth outcomes and maternal obesity. Clinical guidelines addressing healthy weight before, during, and after pregnancy have been introduced in some countries, but at present a systematic accounting for these policies has not been conducted. The objective of the present study was to conduct a cross-national comparison of maternal weight guidelines.

Objective: To investigate long‐term body mass index (BMI) changes associated with childbearing.Design and Methods: Adjusted mean BMI changes were estimated by race‐ethnicity, baseline BMI, and parity using longitudinal regression models for 3,943 young females over 10 and 25 year follow‐up from the ongoing 1979 National Longitudinal Survey of Youth cohort.Results: Estimated BMI increases varied by group, ranging from a low of 2.1 BMI units for white, non‐overweight nulliparas over the first 10 years to a high of 10.1 BMI units for black, overweight multiparas over the full 25‐year follow‐up. Impacts of parity were strongest among overweight multiparas and primaparas at 10 years, ranges 1.4‐1.7 and 0.8‐1.3 BMI units, respectively. Among non‐overweight women, parity‐related gain at 10 years varied by number of births among black and white but not Hispanic women. After 25 years, childbearing significantly increased BMI only among overweight multiparous black women.Conclusion: Childbearing is associated with permanent weight gain in some women, but the relationship differs by maternal BMI in young adulthood, number of births, race‐ethnicity, and length of follow‐up. Given that overweight black women may be at special risk for accumulation of permanent, long‐term weight after childbearing, effective interventions for this group are particularly needed.