Doctor, Am I Gaining Too Much Weight This Pregnancy?
Proper weight gain during pregnancy is an extremely important goal. Discussing weight gain during pregnancy can be very uncomfortable, and it has been reported that weight gain is discussed by only half of doctors. Inappropriate weight gain during pregnancy can not only cause negative effects on the pregnancy, fetus, and delivery, but can cause long term effects as well.
Evidence is clear that excessive weight gain in normal weight patients can lead to larger babies, more difficult deliveries, difficulty losing the weight post-partum, pregnancy associated blood pressure problems and Gestational Diabetes, as well as an increased need for C-Section delivery.
Patients who are obese encounter the same problems, regardless of weight gain, but can lower their risks by restricting weight gain. There is further evidence that proper weight gain in pregnancy reduces the chances of adiposity in the patient’s child. Obesity and marked weight gain in pregnancy have also been associated with weight retention after delivery and ultimately an increase in blood pressure and diabetes later on in life.
In 2009, the Institute of Medicine revised their recommendations for weight gain during pregnancy, based on a large number of studies. The Institute uses Body Mass Index (BMI) as a measure of body habitus. BMI takes into consideration the patient’s weight relative to her height. Since 2009, multiple studies have supported the benefits of the Institute’s recommendations.
Here are the recommendations:
Patient Weight BMI Rec Weight Gain (total) Rec Wt Gain /week
Underweight less 18.5 28-40 lbs 1-1.3lbs
Normal weight 18.5-24.9 25-35lbs 1 lb
Overweight 25-29.9 15-25 0.6 lbs
Obese 30 & above 11-20 0.4 – 0.5lbs
There are some who believe that these guidelines may be too lenient, for there is some evidence that weight can even be restricted more in the obese patients without adverse effects on the fetus and improved weight loss post-partum. A recent study incorporated a program of diet, exercise, calorie consumption and demonstrated marked improvement in appropriate weight gain during pregnancy as well as more rapid weight loss post-partum. It is certainly in the patient’s best interest to gain appropriate weight during her pregnancy.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075048/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3095501/
