Maternal fat intake ( n = 25 ) might be associated with gestational weight gain as suggested by observational studies , although the direction of this association might depend on specific types of fat ( e.g. , saturated fat ) .
Macronutrient intake was not consistently associated with the prevalence of inadequate or excessive gestational weight gain .
CONCLUSIONS The current literature provides evidence that energy intake is associated with gestational weight gain , but the roles of individual macronutrients are inconsistent .
BACKGROUND  Abnormal gestational weight gain is associated with unfavorable pregnancy outcomes .
Several risk factors have been identified , but the effect of macronutrient intake during pregnancy on gestational weight gain has not been systematic ally evaluated in both high-income countries and low- and middle-income countries .
Excessive Early Gestational Weight Gain and Risk of Gestational Diabetes Mellitus in Nulliparous Women
OBJECTIVE : To estimate whether there is an association between excessive early gestational weight gain and the development of gestational diabetes mellitus ( GDM ) and excessive fetal growth . METHODS : This is a secondary analysis of a r and omized controlled trial of vitamins C and E in nulliparous low-risk women . Maternal weight gain from prepregnancy ( self-reported ) to 15–18 weeks of gestation was measured , and expected gestational weight gain was determined using the Institute of Medicine 2009 guidelines for each prepregnancy body mass index category . Excessive early gestational weight gain was defined as gestational weight gain greater than the upper range of the Institute of Medicine guidelines . Rates of GDM , birth weight greater than 4,000 g , and large for gestational age ( LGA , birth weight 90th percentile or higher ) were calculated and compared between women with excessive early gestational weight gain and early nonexcessive gestational weight gain ( within or below Institute of Medicine guidelines ) . RESULTS : A total of 7,985 women were studied .  Excessive early gestational weight gain occurred in 47.5 % of women . Ninety-three percent of women with excessive early gestational weight gain had total gestational weight gain greater than Institute of Medicine guidelines . In contrast , only 55 % of women with nonexcessive early gestational weight gain had total gestational weight gain greater than Institute of Medicine guidelines ( P<.001 ) . Rates of GDM , LGA , and birth weight greater than 4,000 g were higher in women with excessive early gestational weight gain . CONCLUSION : In our population , excessive early gestational weight gain occurred in 93 % of women who had total gestational weight gain greater than the Institute of Medicine guidelines . In low-risk nulliparous women , excessive early gestational weight gain is associated with the development of GDM and excessive fetal growth . LEVEL OF EVIDENCE :
Maternal fat intake ( n = 25 ) might be associated with gestational weight gain as suggested by observational studies , although the direction of this association might depend on specific types of fat ( e.g. , saturated fat ) .
Macronutrient intake was not consistently associated with the prevalence of inadequate or excessive gestational weight gain .
CONCLUSIONS The current literature provides evidence that energy intake is associated with gestational weight gain , but the roles of individual macronutrients are inconsistent .
BACKGROUND  Abnormal gestational weight gain is associated with unfavorable pregnancy outcomes .
Several risk factors have been identified , but the effect of macronutrient intake during pregnancy on gestational weight gain has not been systematic ally evaluated in both high-income countries and low- and middle-income countries .