A nurse is reinforcing teaching with a client who is pregnant and has a body mass index (BMI) of 26.5. She asks the nurse how much weight she should gain over the course of her pregnancy. Which of the following statements is an appropriate response by the nurse?

Choice A rationale A weight gain of 25 to 35 pounds is the general recommendation for women who begin pregnancy with a normal body mass index (BMI) of 18.5 to 24.9. Since the client has a BMI of 26.5, she falls into the overweight category, and her recommended weight gain range is different to optimize maternal and fetal outcomes. Choice B rationale For pregnant individuals who are classified as overweight, defined by a BMI of 25.0 to 29.9, the recommended total weight gain during pregnancy is 15 to 25 pounds (approximately 6.8 to 11.3 kg). This guideline aims to minimize risks such as gestational diabetes, preeclampsia, and macrosomia while ensuring adequate fetal growth. Choice C rationale A weight gain of 11 to 20 pounds is the recommendation for pregnant individuals who are classified as obese, with a BMI of 30.0 or greater. This client's BMI of 26.5 places her in the overweight category, not obese, necessitating a different target range for gestational weight gain to promote healthy outcomes. Choice D rationale While a healthy diet is crucial during pregnancy, the exact amount of weight gained does matter for both maternal and fetal health outcomes. Excessive or insufficient weight gain can lead to various complications, including gestational diabetes, preeclampsia, preterm birth, and abnormal fetal growth, thus specific weight gain targets are important.