Sources: 2012 Pregnancy Risk Assessment Monitoring Systems for five states (Arkansas, Hawaii, Maine, New Jersey, Rhode Island) and 2013 birth certificates for 41 states, New York City, and District of Columbia.
*Gestational weight gain above Institute of Medicine recommendations, which are based on prepregnancy body mass index (BMI): 28–40 pounds for underweight women (BMI <18.5), 25–35 pounds for normal-weight women (BMI = 18.5–24.9), 15–25 pounds for overweight women (BMI = 25.0–29.9), and 11–20 pounds for obese women (BMI ≥30.0).