Expected Weekly Weight Gain at 23-27 Weeks Gestation
For a pregnant woman with normal pre-pregnancy BMI (18.5-24.9 kg/m²) at 23-27 weeks gestation, the expected weekly weight gain is 0.5-0.9 kg per week, which translates to approximately 0.5-0.9 kg weekly during this second trimester period. 1, 2
Weight Gain by Pre-Pregnancy BMI Category
The expected weekly weight gain during 23-27 weeks gestation varies significantly based on pre-pregnancy BMI:
Normal Weight Women (BMI 18.5-24.9 kg/m²)
- Weekly gain: 0.5-0.9 kg per week throughout the second and third trimesters 1, 2
- This rate should be steady and progressive from approximately week 14 through delivery 1
- Total expected gain by this point: approximately 1.4-2.3 kg from first trimester plus 5-9 kg accumulated during weeks 14-27 2
Underweight Women (BMI <18.5 kg/m²)
- Weekly gain: 0.5-0.9 kg per week during second and third trimesters 2
- These women require higher total pregnancy weight gain (up to 18 kg) but follow similar weekly rates 1, 2
Overweight Women (BMI 25-29.9 kg/m²)
- Weekly gain: approximately 0.25-0.45 kg per week (less than 50% of the rate for normal-weight women) 2
- This reduced rate helps limit total pregnancy weight gain to 7-11.5 kg 1
Obese Women (BMI ≥30 kg/m²)
- Weekly gain: minimal, significantly less than 0.5 kg per week 2
- Total pregnancy weight gain should be limited to 5-9 kg, with some guidelines recommending approximately 7 kg total 1, 3
- Recent evidence suggests that weight gain below current recommendations or even weight loss may be safe in class 3 obesity 4
Supporting Evidence and Context
The American College of Obstetricians and Gynecologists guidelines emphasize that weight gain should be linear at approximately 1.06 pounds (0.48 kg) per week after week 20 for normal-weight women, which aligns with the 0.5-0.9 kg weekly range 1, 5. Research from the INTERGROWTH-21st Project found mean weight gains of 2.86 kg during the 24-28 week window in healthy women with normal BMI 6.
Clinical Considerations at 23-27 Weeks
Common pitfalls to avoid:
- By 20-30 weeks, many overweight and obese women have already exceeded recommended upper limits for total pregnancy weight gain 7
- Approximately 49% of pregnant women exceed total gestational weight gain guidelines, with excess gain most marked in those with pre-pregnancy overweight or obesity 7
- The median weight gain for overweight women exceeds recommended upper limits by approximately 20 weeks' gestation 7
Nutritional support during this period:
- Energy intake should be increased by 300 kcal/day above baseline needs during the second trimester 1, 2
- Protein intake should be 0.75 g/kg/day plus an additional 10 g/day 1, 2
- Iron supplementation of 30 mg/day is recommended during the second trimester 2
Practical Application
To assess appropriate weight gain at 23-27 weeks:
- Calculate pre-pregnancy BMI to determine the appropriate weekly target 1
- Expected cumulative gain by week 27 for normal BMI: approximately 8-14 kg (1.4-2.3 kg first trimester + 6.5-11.7 kg from weeks 14-27) 1, 2
- Monitor that weight gain trajectory remains steady rather than accelerating, as excessive early gain predicts total excessive gain 7