Pregnant women with a body mass index of 35 or higher who lost weight or gained less than the recommended 11 to 20 pounds had a lower risk of having a large baby or undergoing cesarean section than those in the recommended weight-gain range, according to a study of more than 46,000 obese pregnant women published in Obstetrics & Gynecology. The researcher said the study suggests that gaining less than the recommended weight or even losing pounds is "at least not harmful" for severely obese pregnant women, although the study did not determine a safe weight-loss range.

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