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38-2.13]) but not among those with overweight or obesity (adjusted relative risk = 0.98 [95% CI 0.91-1.05]). When evaluated as a z score, prepregnancy weight gain was associated with higher GWG among women with and without overweight or obesity (mean = 0.24 [0.10] and 0.28 [0.12] z score, respectively). Weight gain before pregnancy is associated with higher GWG during pregnancy. Assessment of prepregnancy weight changes may identify those at risk for high GWG. Weight gain before pregnancy is associated with higher GWG during pregnancy.