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Weight Gain
in Pregnancy: How Much, How Little?
With new guidelines issued for
weight gain during pregnancy, you may wonder whether the concern
is women gaining too much or not enough. The answer is both.
An eating disorder in which women are so afraid of weight gain
that they reduce calorie consumption and exercise excessively
puts their babies at risk. However, in the United States, the
far more common problem is gaining too much weight during pregnancy,
which can lead to short- and long-term risks for both mother
and baby.
There’s no single perfect
weight gain figure for all women but there are general guidelines.
Yet some estimates say that as many as 70 percent of women do
not keep weight gain within recommended boundaries. |
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Too little and too much gain
both risky
Gaining more than 35 pounds puts
normal weight women at increased risk for cesarean delivery,
high birth weight babies and possibly preeclampsia. An American
Institute for Cancer Research report found that baby girls of
higher birth weight are probably more likely than those born
at normal weight to develop premenopausal breast cancer as adults.
Mothers are also likely to retain extra weight after pregnancy,
raising their risk of a variety of health problems.
Gaining too little weight is
also an immediate and long-term concern. Distorted body image
views and books and Web sites promoting overly restrictive food
choices may lead some women to gain unhealthfully little. Low
birth weight babies are more vulnerable to infections and face
increased risk of death and disease and also increased risk in
adulthood of heart disease and diabetes.
For most women, the new recommendations
don’t change their weight gain target, just the emphasis
on achieving it. Underweight women (BMI less than 18.5) should
gain 28 to 40 pounds during pregnancy; normal-weight women (whose
BMI falls between 18.5 and 24.9) should gain 25 to 35 pounds;
and overweight women (with BMI 25 to 29.9) should gain 15 to
25 pounds. Women carrying twins have higher weight gain targets.
New recommendations for obese
women
The major change in recommended
weight gain is for the estimated 28 percent of women of childbearing
age who are now obese. Defined by a body mass index of 30 or
more, at 5 feet 5 inches, this includes women 180 pounds and
over.
Once urged to gain at least 15
pounds during pregnancy, experts now recommend obese women gain
11 to 20 pounds by eating a balanced diet (which may
mean 2000 to 3500 calories a day). These women have fewer
cesarean deliveries, develop diabetes or hypertension during
pregnancy less often, retain less weight after birth, and are
less likely to have a high birth weight baby compared to those
who gain more.
Recommending more attention
to weight before and during pregnancy
Because excessive weight gains
are so common, the recommendations’ report emphasizes that
women should aim to conceive while at a normal BMI and gain within
the guidelines during pregnancy. More than half of U.S. women
ages 20 to 39 are overweight or obese. In pregnancy, obese women
are more likely than normal weight women to face gestational
diabetes and hypertension, pre-eclampsia, birth defects, cesarean
delivery and excessively large babies. |
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