“It’s important for expecting mothers to work closely with their physician and perhaps even a registered dietitian to achieve a healthy weight gain during pregnancy,” said Dr. Nancy Butte, professor of pediatrics – nutrition at BCM.
New guidelines issued
Because of the concerns related to the obesity epidemic in the United States, the Institute of Medicine issued new guidelines for healthy weight gain during pregnancy. Butte served on the panel that made these recommendations.
“Over 50 percent of reproductive women between the ages of 20 and 30 in the United States are overweight or obese,” said Butte. “In pregnant women, this can cause increased risks during the time of delivery and poor outcomes for the baby, including risk of obesity and diabetes later.”
Being overweight or obese can also increase the chances of having a cesarean section, said Butte.
Recommended weight gain
The Institute of Medicine makes the following recommendations for weight gain during pregnancy based on a woman’s pre-pregnancy Body Mass Index:
Pre-pregnancy BMI – Underweight (less than 18.5 kg/m2)
- Total weight gain range (pounds): 28.0 to 40.0
- Rates of weight gain in second and third trimesters (pounds per week): 1.0 (1.0 to 1.3)
Pre-pregnancy BMI – Normal Weight (18.5 to 24.9 kg/m2)
- Total weight gain range (pounds): 25.0 to 35.0
- Rates of weight gain in second and third trimesters (pounds per week): 1.0 (0.8 to 1.0)
Pre-pregnancy BMI – Overweight (25.0 to 29.9 kg/m2)
- Total weight gain range (pounds): 15.0 to 25.0
- Rates of weight gain in second and third trimesters (pounds per week): 0.6 (0.5 to 0.7)
Pre-pregnancy BMI – Obese (30.0 or higher kg/m2)
- Total weight gain range (pounds): 11.0 to 20.0
- Rates of weight gain in second and third trimesters (pounds per week): 0.5 (0.4 to 0.6)
Chart weight gain
Butte suggests that obstetricians should chart women’s weight gain and review the results with them so they can become aware of their progress toward the recommended range. If there is unusual weight gain, it can mean there is another issue, such as water retention, that the physician may address. Women should be provided with individualized advice about both diet and physical activity. This may require referral to a dietitian who can provide a pregnant woman with the tools she needs to maintain a healthy weight during pregnancy, including recommendations for incorporating proper diet and physical activity into her daily routine.
There is also concern for postpartum weight retention, Butte says, and she suggests counseling from a registered dietitian may need to continue into the postpartum period. This would give women the support to return to their pre-pregnant weight within the first year and to have a better chance of returning to a normal BMI value at the time of the next conception.
For women who are trying to get pregnant, Butte suggests trying to fall within the normal-weight BMI range, which helps with infertility and prevention of metabolic syndrome, a group of risk factors that increase the risk of coronary artery disease, stroke and type 2 diabetes.
For more information on the guidelines, visit the Institute of Medicine web site.