Both too little and too much weight gain during pregnancy are associated with serious maternal and child health outcomes, including preterm birth, low birth weight, death, preeclampsia, and unplanned cesarean delivery. Women in low- and middle-income countries often face challenges such as food insecurity, poor diet, limited health care access, and inadequate micronutrient supplements, all of which contribute to unhealthy weight during pregnancy.
A review of pregnancy health promotion programs in low- and middle-income countries, led by Priscilla Aba Aggrey, found that nutrition, education, and physical activity interventions delivered early in pregnancy can help women achieve optimal gestational weight gain.
"Interventions delivered during pregnancy, especially when started early and tailored to local contexts, can reduce both inadequate and excessive gestational weight gain. The most effective approach depends on the type of intervention and the woman's nutritional or weight status, which highlights the need for personalized interventions," said Aggrey, a PhD in public health in the Department of Global and Community Health .
The interventions reviewed included pharmacological therapies, nutritional supplementation, promotion of healthy eating, education and counseling, physical activity, and combined diet-and-exercise programs on gestational weight gain among pregnant women in low- and middle-income countries.
Aggrey and Assistant Professor Dongqing Wang , who published this work in the journal BMJ Global Health, found that:
Physical activity during pregnancy was more effective at reducing excessive weight gain.
Women who received multiple micronutrient supplements were more likely to have optimal weight gain during pregnancy compared to women who received iron-folic acid supplementation alone. Education and counseling helped pregnant women maintain optimal weight gain, especially when the counseling was culturally tailored and nutrition-focused.
Combined diet-and-physical-activity interventions, such as personalized dietary guidance, supervised exercise, and healthy-eating reminders, were effective in reducing excessive gestational weight gain.
"Policymakers and health care providers in low- and middle-income countries can adopt these interventions and incorporate them into routine prenatal care to help pregnant women achieve healthy weight gain outcomes and reduce preventable complications for both mothers and babies," said Aggrey.
The effects of antenatal interventions on gestational weight gain in low and middle-income countries: a systematic review was published in April 2026 in BMJ Global Health.
