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. 2026 May 29;16(5):e112189. doi: 10.1136/bmjopen-2025-112189

Table 2. Comparison of optimal GWG in this study and IOM recommendation.

Group Estimated GWG Kappa value Determined GWG
N (IQR) RCS This study IOM
Underweight 395 (18.0–25.0) 18.5–25.0 0.92 18.0–25.0 –
Normal weight 2577 (15.0–24.0) 14.0–24.0 0.91 14.0–24.0 17.0–25.0
Overweight 383 (12.5–21.0) 12.2–24.0 0.75 12.2–24.0 14.0–23.0
Obesity 81 (13.3–20.0) 13.3–19.8 0.89 13.3–20.0 11.0–19.0

GWG, gestational weight gain; IOM, Institute of Medicine; RCS, restricted cubic spline.