 This systematic review found that women in the United States and Western Europe had higher pre-pregnancy BMI and higher rates of excessive gestational weight gain, GWG, than women in East Asia. When using regional BMI categories in East Asia, however, rates of GWG above guidelines were similar across the three continents. Excessive GWG was associated with adverse pregnancy outcomes across all regions, regardless of whether regional or worldwide BMI categories were used. This article was authored by Rebecca F. Goldstein, Sally K. Abel, Sanjeeva Rana Sr., and others.