Extra Pounds During and Between Pregnancies Can Pose Problems

Don't eat for 2, because complications increase with excess weight

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By
HealthDay Reporter

SATURDAY, April 19, 2008 (HealthDay News) -- Pregnancy has long been considered a kind of gastronomical free-for-all. After all, a pregnant woman has to nourish two bodies with the food she eats, right?

The problem is, the baby's nutritional needs are only around 300 calories a day, and extra weight gain can increase the risk of pregnancy complications for both mother and child.

And, weight concerns don't stop after the baby is born, because extra weight gain after pregnancy increases the risk of complications in subsequent pregnancies, even if a woman never gains enough to be considered overweight.

"Women think they have carte blanche to eat whatever they want during pregnancy, but that's not a good idea," said Dr. Miriam Greene, a clinical assistant professor of obstetrics and gynecology at New York University Medical Center and the author of the book, Frankly Pregnant: A Candid, Week-by-Week Guide to the Unexpected Joys, Raging Hormones, and Common Experiences of Pregnancy.

"If you eat for two, you'll end up with complications you didn't need to take on. Eat what your appetite tells you to eat, and eat slowly, so you can tell when you're full," advised Dr. Marjorie Greenfield, an obstetrician at MacDonald Women's Hospital at Case Medical Center, University Hospitals in Cleveland, and author of the book, The Working Woman's Pregnancy Book.

During pregnancy, an average-weight woman should gain about 25 to 35 pounds, according to Greene. "You don't want your weight gain to be less than 15 or greater than 40," she said.

But many women aren't heeding that advice. A recent report from the Institute of Medicine (IOM) found that about one-quarter of American women gain more than 40 pounds during their pregnancy. The IOM is currently reviewing its guidelines on pregnancy weight gain and expects to issue new guidelines during the summer of 2009.

In the meantime, the IOM recommends that women with a body mass index (BMI, a ratio of weight to height) of less than 18.5 should gain 28 to 40 pounds during pregnancy, while women with an average BMI -- 18.5 to 24.9 -- should keep weight gain between 25 and 35 pounds. Overweight women with BMIs of 25 to 29.9 should try to gain between 15 and 25 pounds throughout their pregnancy, and obese women with BMIs over 30 need only gain 15 pounds.

Gaining too much weight during pregnancy puts both baby and mom at risk of complications, such as gestational diabetes and high blood pressure, labor complications, stillbirth and delivery of a large-for-gestational age baby, according to the March of Dimes.

Greene said about two-thirds of her patients manage to stay within the guidelines. And those who don't are very disappointed at how hard the weight is to get off afterward.

She recommends that her pregnant patients eat well-balanced diets and that they don't give in to every food craving. "It's not healthy to gain weight eating pints of ice cream," she said.

Greenfield is also a fan of most exercises during pregnancy. Not only can exercise help you stave off pregnancy weight gain, it improves overall well-being as well, she said.

"Pregnancy is a special time when a lot of women will take better care of themselves to take care of the baby. It's a golden opportunity to take care of yourself, and you may have an impact on your health and your baby's health in the long run," Greenfield noted.

And, it's not just during pregnancy that women have to be concerned about extra pounds. A recent study found that every one or two point increase in a woman's BMI between pregnancies translated to an increased risk of gestational diabetes, high blood pressure and delivering a large baby by 20 percent to 40 percent. Women who increased their BMI more than three points between pregnancies had a 63 percent increased risk of delivering a stillborn baby.

The increases in the risks of complications held true even if the BMI changes didn't place a woman into the overweight or obese category, the study found.

More information

To learn more about weight gain during pregnancy, visit the American Pregnancy Association.

SOURCES: Miriam Greene, M.D., clinical assistant professor of obstetrics and gynecology, New York University Medical Center; Marjorie Greenfield, M.D., obstetrician/gynecologist, MacDonald Women's Hospital at Case Medical Center, University Hospitals, Cleveland; The Lancet

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