Background: Gestational weight gain (GWG) is a critical determinant of maternal and neonatal outcomes. Both inadequate and excessive GWG have been linked to adverse birth outcomes, yet evidence from low and middle income countries remains limited.

Objective: To assess GWG among pregnant women and examine its association with selected birth outcomes in Eastern India.

Methods: A hospital based prospective observational study was conducted among 220 pregnant women attending antenatal clinics and delivering at a tertiary care hospital in Bhubaneswar, Odisha. GWG was classified according to Institute of Medicine guidelines. Birth outcomes including birth weight, gestational age at delivery, and mode of delivery were analyzed us sing chi square tests and multivariate logistic regression.

Results: Of the participants, 39.1% had inadequate GWG, 42.3% adequate, and 18.6% excessive. Inadequate GWG was significantly associated with low birth weight (AOR 2.8; 95% CI 1.5–5.1; p<0.001) and preterm birth (AOR 2.3; 95% CI 1.2–4.4; p=0.01). Excessive GWG was strongly associated with macrosomia (AOR 3.1; 95% CI 1.5–6.4; p=0.002) and increased caesarean section rates (AOR 2.4; 95% CI 1.3–4.6; p=0.006).

Conclusions: Both inadequate and excessive GWG were significantly associated with adverse birth outcomes. These findings highlight the dual burden of maternal undernutrition and overnutrition in India and underscore the importance of routine GWG monitoring and individualized counselling during antenatal care.

Implications: Integrating structured nutritional counselling and regular weight monitoring into antenatal services can optimize GWG, reduce adverse outcomes, and contribute to long term maternal and child health

TBA