Body Composition Changes in Pregnancy: Measurement, Predictors and Outcomes

Overview

Journal Eur J Clin Nutr

Specialty Nutritional Sciences

Date 2014 Mar 27

PMID 24667754

Citations 67

Authors

E M Widen

D Gallagher

Affiliations

Soon will be listed here.

Abstract

Prevalence of overweight and obesity has risen in the United States over the past few decades. Concurrent with this rise in obesity has been an increase in pregravid body mass index and gestational weight gain affecting maternal body composition changes in pregnancy. During pregnancy, many of the assumptions inherent in body composition estimation are violated, particularly the hydration of fat-free mass, and available methods are unable to disentangle maternal composition from fetus and supporting tissues; therefore, estimates of maternal body composition during pregnancy are prone to error. Here we review commonly used and available methods for assessing body composition changes in pregnancy, including: (1) anthropometry, (2) total body water, (3) densitometry, (4) imaging, (5) dual-energy X-ray absorptiometry, (6) bioelectrical impedance and (7) ultrasound. Several of these methods can measure regional changes in adipose tissue; however, most of these methods provide only whole-body estimates of fat and fat-free mass. Consideration is given to factors that may influence changes in maternal body composition, as well as long-term maternal and offspring outcomes. Finally, we provide recommendations for future research in this area.

Citing Articles

Gestational weight trajectory and early offspring growth differed by gestational diabetes: a population-based cohort study.

Huang Y, Ainiwan D, Qiu Y, Zhang L, Alifu X, Cheng H Nutr Diabetes. 2025; 15(1):10.

PMID: 40075061 PMC: 11904208. DOI: 10.1038/s41387-025-00365-y.

Protocol for a randomised controlled trial of a weight maintenance intervention to promote fat loss in pregnant individuals with obesity.

Redman L, Phelan S, Apolzan J, Beyl R, Altazan A, Dickey M BMJ Open. 2025; 15(2):e095804.

PMID: 40000086 PMC: 11865736. DOI: 10.1136/bmjopen-2024-095804.

Pre-pregnancy obesity and weight gain during pregnancy: impact on newborn outcomes.

Gunes S, Sahin S, Koyuncu Arslan M, Korkmaz N, Karaca Dag O, Gokalp E BMC Pediatr. 2025; 25(1):30.

PMID: 39810166 PMC: 11730788. DOI: 10.1186/s12887-024-05381-y.

Anthropometric Measurements and Laboratory Methods for Pregnancy: An Update Review to Evaluation of Body Composition.

Acar Y, Koksal E Curr Nutr Rep. 2025; 14(1):13.

PMID: 39776373 PMC: 11706875. DOI: 10.1007/s13668-024-00597-x.

Anthropometric measurements as predictors of nutritional status in black South African women during pregnancy.

Erasmus C, Maharaj N, Chuturgoon A J Obstet Gynaecol Res. 2024; 51(1):e16184.

PMID: 39721601 PMC: 11669476. DOI: 10.1111/jog.16184.

References

Prentice A, Goldberg G, Davies H, Murgatroyd P, Scott W . Energy-sparing adaptations in human pregnancy assessed by whole-body calorimetry. Br J Nutr. 1989; 62(1):5-22. DOI: 10.1079/bjn19890004. View

Hopkinson J, Butte N, Ellis K, Wong W, Puyau M, Smith E . Body fat estimation in late pregnancy and early postpartum: comparison of two-, three-, and four-component models. Am J Clin Nutr. 1997; 65(2):432-8. DOI: 10.1093/ajcn/65.2.432. View

Brozek J, Grande F, Anderson J, Keys A . DENSITOMETRIC ANALYSIS OF BODY COMPOSITION: REVISION OF SOME QUANTITATIVE ASSUMPTIONS. Ann N Y Acad Sci. 1963; 110:113-40. DOI: 10.1111/j.1749-6632.1963.tb17079.x. View

Huston Presley L, Wong W, Roman N, Amini S, Catalano P . Anthropometric estimation of maternal body composition in late gestation. Obstet Gynecol. 2000; 96(1):33-7. DOI: 10.1016/s0029-7844(00)00857-7. View

Ritchie L, Fung E, Halloran B, Turnlund J, Van Loan M, Cann C . A longitudinal study of calcium homeostasis during human pregnancy and lactation and after resumption of menses. Am J Clin Nutr. 1998; 67(4):693-701. DOI: 10.1093/ajcn/67.4.693. View

Hutcheon J, Platt R, Abrams B, Himes K, Simhan H, Bodnar L . A weight-gain-for-gestational-age z score chart for the assessment of maternal weight gain in pregnancy. Am J Clin Nutr. 2013; 97(5):1062-7. PMC: 3625243. DOI: 10.3945/ajcn.112.051706. View

Popkin B . The nutrition transition: an overview of world patterns of change. Nutr Rev. 2004; 62(7 Pt 2):S140-3. DOI: 10.1111/j.1753-4887.2004.tb00084.x. View

Contreras Campos M, Rodriguez-Cervantes N, Reza-Lopez S, Avila-Esparza M, Chavez-Corral D, Levario-Carrillo M . Body composition and newborn birthweight in pregnancies of adolescent and mature women. Matern Child Nutr. 2012; 11(2):164-72. PMC: 6860337. DOI: 10.1111/j.1740-8709.2012.00434.x. View

Lederman S, Paxton A, Heymsfield S, Wang J, Thornton J, Pierson Jr R . Body fat and water changes during pregnancy in women with different body weight and weight gain. Obstet Gynecol. 1997; 90(4 Pt 1):483-8. DOI: 10.1016/s0029-7844(97)00355-4. View

10.

Butte N, Ellis K, Wong W, Hopkinson J, OBrian Smith E . Composition of gestational weight gain impacts maternal fat retention and infant birth weight. Am J Obstet Gynecol. 2003; 189(5):1423-32. DOI: 10.1067/s0002-9378(03)00596-9. View

11.

Adair L, Pollitt E, Mueller W . Maternal anthropometric changes during pregnancy and lactation in a rural Taiwanese population. Hum Biol. 1983; 55(4):771-87. View

12.

Fanelli M, Kuczmarski R . Ultrasound as an approach to assessing body composition. Am J Clin Nutr. 1984; 39(5):703-9. DOI: 10.1093/ajcn/39.5.703. View

13.

Naylor K, Iqbal P, Fledelius C, Fraser R, Eastell R . The effect of pregnancy on bone density and bone turnover. J Bone Miner Res. 2000; 15(1):129-37. DOI: 10.1359/jbmr.2000.15.1.129. View

14.

Denne S, Patel D, Kalhan S . Total body water measurement in normal and diabetic pregnancy: evidence for maternal and amniotic fluid equilibrium. Biol Neonate. 1990; 57(5):284-91. DOI: 10.1159/000243203. View

15.

Moller U, Vid Streym S, Mosekilde L, Rejnmark L . Changes in bone mineral density and body composition during pregnancy and postpartum. A controlled cohort study. Osteoporos Int. 2011; 23(4):1213-23. DOI: 10.1007/s00198-011-1654-6. View

16.

Wang Z, Deurenberg P, Wang W, Pietrobelli A, Baumgartner R, Heymsfield S . Hydration of fat-free body mass: review and critique of a classic body-composition constant. Am J Clin Nutr. 1999; 69(5):833-41. DOI: 10.1093/ajcn/69.5.833. View

17.

Lederman S, Paxton A, Heymsfield S, Wang J, Thornton J, Pierson Jr R . Maternal body fat and water during pregnancy: do they raise infant birth weight?. Am J Obstet Gynecol. 1999; 180(1 Pt 1):235-40. DOI: 10.1016/s0002-9378(99)70181-x. View

18.

Deierlein A, Siega-Riz A, Adair L, Herring A . Effects of pre-pregnancy body mass index and gestational weight gain on infant anthropometric outcomes. J Pediatr. 2010; 158(2):221-6. PMC: 3017634. DOI: 10.1016/j.jpeds.2010.08.008. View

19.

Catalano P, Wong W, Drago N, Amini S . Estimating body composition in late gestation: a new hydration constant for body density and total body water. Am J Physiol. 1995; 268(1 Pt 1):E153-8. DOI: 10.1152/ajpendo.1995.268.1.E153. View

20.

Taggart N, Holliday R, Billewicz W, HYTTEN F, Thomson A . Changes in skinfolds during pregnancy. Br J Nutr. 1967; 21(2):439-51. DOI: 10.1079/bjn19670045. View