NEW YORK - The standard advice for how much weight a woman should gain during pregnancy may need to be changed, concludes a study suggesting that even accepted weight gains may raise the risk of having an overweight toddler.

Women in the study who gained the recommended amount of weight had four times the risk of having a child who was overweight at age 3, compared with women who gained less than the advised amount.

So what's a pregnant woman to do? Clearly, she shouldn't gain more weight than recommended, said the study's lead author, Dr. Emily Oken of Harvard Medical School.

But beyond that, it's too early to say whether women should try to gain less than the standards call for or aim for the low end of the recommended range, probably the safer course, Dr. Oken said.

The study appears in the April issue of the American Journal of Obstetrics & Gynecology. It focuses on guidelines issued in 1990 by the Institute of Medicine, a private nongovernmental organization that advises the federal government.

The guidelines recommend differing amounts of weight gain depending on how much a woman weighed before pregnancy, as measured by a combination of her height and weight called the body-mass index.

The new study looked at 1,044 pairs of mothers and their 3-year-olds. It compared how much weight the mother had gained during pregnancy with the BMI of their children. It defined "overweight" in the 3-year-olds as having a body-mass index greater than 95 percent of children of the same age and sex.

Researchers found that about half the mothers gained more weight during pregnancy than the guidelines called for, while about a third met the recommended gain. The remaining 14 percent gained less weight than recommended.

Analysis suggested that poor health habits shared by mother and child don't account for the outcome, she said. And while the women in the study generally had health insurance and were well-educated, studies of other groups are finding similar results, she said.

Dr. Oken said gaining too much weight raises the risk for having a baby that is too large, which may lead to a difficult delivery or Caesarean section, she said.

Dr. Lisa Bodner, an assistant professor of epidemiology and obstetrics-gynecology at the University of Pittsburgh Graduate School of Public Health, says the new work adds to previous indications that the current guidelines may need to be revised.

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