Objective. The purpose of this study was to examine the differences between women who reported current and past physical or sexual abuse and those who did not in terms of mean total prenatal weight change, the odds for inadequate prenatal gain, and the odds for excessive prenatal gain. Methods. This study used a matched retrospective cohort design. Data were from the charts of 578 clients of an urban prenatal care clinic. Multiple regression analyses, stratified by maternal age, were conducted to examine the association of past and current abuse with total prenatal weight change and with adequacy of prenatal weight gain for Body Mass Index category. Results. For teens, abuse was not associated with prenatal weight change. For adults, mean total gains were 6.9 pounds greater for those who reported current abuse than for those who reported no abuse. Compared to women who reported no abuse, adults who reported only a history of physical abuse had 3.1 times the odds, and those who reported a history of sexual abuse (with or without physical abuse) had 3.0 times the odds for inadequate prenatal weight gains. Adults who reported a history of sexual abuse were 2.4 times as likely to have excessive prenatal weight gains as adults who reported no abuse. Conclusions. The relationship of abuse and prenatal weight gain was different in adults and teens. This study may be the first to report an association between abuse and excessive prenatal gains, suggesting that addressing the psychosocial needs of women may help optimize prenatal weight gain.