Excessive deposition of central body and abdominal (centripetal) fat early in life often will presage the later development of cardiovascular and metabolic diseases. Data from urban, low-income women from Camden, New Jersey, were used to examine the influence of gestational weight gain on patterns of weight change and fat deposition in 118 young women followed over two consecutive pregnancies. Adjusting for confounding factors, there was a significant (P < 0.05) dose-response relationship between the amount of gestational gain (in the subsequent pregnancy) and increases in postpartum weight compared with the postpartum in the prior pregnancy: +1.5 kg with a low gain, +2.9 kg with recommended amounts of gain, and +7.9 kg with excessive gain. Excessive gain (18+ kg) was common (18%) in the sample. The incidence of "new" obesity (body mass index [BMI] >29.0 in the subsequent postpartum but not the index postpartum) increased significantly with gestational gain: 4.7% with low gain, 7.0% with recommended gains, and 25.0% with excessive gain. There were similar dose-response increases related to gestational weight gain in all skinfolds (suprailiac, subscapular, and triceps) and the sum of the skinfolds. However, in women with excessive gains, fat was increased disproportionately at upper (+52%) and lower (+48%) central body sites, compared with the periphery (+27%), and compared with increases in women with lesser gestational gains. Thus, excessive gestational weight gain, which is common among low-income women, may be a factor which promotes obesity and a centripetal fat pattern during the reproductive years, thereby increasing the risk for cardiovascular and metabolic diseases in later life. Β© 1996 Wiley-Liss, Inc.