Volume 2,Issue 2
Comparative Review of Guidelines on Gestational Weight Management
Gestational weight management is a key strategy for improving perinatal outcomes and safeguarding the long-term, intergenerational health of both mother and child. To address rising rates of maternal obesity and excessive gestational weight gain, guidance and consensus statements have been revised repeatedly in China and internationally. This review compares leading guidelines from China and elsewhere, including IOM 2009, ACOG 2015, FIGO 2023, and NICE 2025, to help guide practice. Across documents, pre-pregnancy body-mass index (BMI) is the primary tool for stratification; lifestyle intervention centred on diet and physical activity is consistently recommended as first-line management; and screening and management of metabolic comorbidities in pregnancy are emphasised. Differences mainly reflect underlying philosophies and implementation pathways: Chinese guidance tends to rely on quantified targets and more frequent monitoring to reduce obstetric risk, whereas some Western guidelines place greater emphasis on life-course management, patient-centred communication, and reducing weight stigma. Important gaps remain, including limited granularity in metabolic risk stratification, insufficient evidence for severe obesity and complex pregnancies, limited practicality of recommended interventions, and delayed guidance on periconception use and management of newer anti-obesity medications. Future efforts should shift from weight-centred targets to broader metabolic health optimisation, supported by multidimensional assessment, integrated physical and psychological care, family engagement, and digitally enabled follow-up—towards more precise, multidisciplinary, and compassionate models of care.
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