Expectant Mothers Limited Weight Gain

Weight management program helped obese pregnant women curb weight gain during and after pregnancy

(RxWiki News) Weight gain is natural during pregnancy, but, for obese women, pregnancy can easily increase their weight to less healthy levels. But weight management programs may help expectant mothers stay healthy.

A recent study found that pregnant women who were obese successfully limited their weight gain while they were pregnant through weight loss programs, such as weekly support groups, nutrition counseling, and keeping food and exercise journals.

The study authors also found that the women who were able to limit their weight gain during pregnancy were less likely to have larger-than-normal babies than women who did not limit their weight gain. Having a big baby can put the mother at risk for birthing complications and raise the baby's risk of obesity later in life.

"Discuss a healthy pregnancy weight plan with your OB-GYN."

"Overweight and obese women are at higher risk for several pregnancy complications, including gestational diabetes mellitus, hypertension, preeclampsia, cesarean delivery and postpartum weight retention," Jamie Walker Erwin, MD, of Baylor All Saints Medical Center, told dailyRx News. "Similarly, babies born to overweight or obese pregnant women are at increased risk for prematurity, stillbirth, congenital anomalies, macrosomia (big babies) with possible birth injury, and childhood obesity."

This study was conducted by Kimberly Vesco, MD, MPH, of the Kaiser Permanente Center for Health Research in Portland, OR, and colleagues.

The study included 114 obese women who were between seven and 21 weeks pregnant and receiving prenatal care at Kaiser Permanente, Northwest, between October 2009 and June 2011.

The study authors randomly split the women into two groups: 56 women were enrolled in a special diet and exercise program and 58 were not asked to change their diet or exercise routines (the control group).

The women in the special program group were told to exercise for at least 30 minutes a day and keep a diet and exercise journal. They had weekly group support sessions.

These women gained an average of 11 pounds by week 34 of pregnancy, versus an average of 18 pounds for the women in the control group.

Two weeks after giving birth, the women in the special program weighed, on average, 6 pounds less than they did at the beginning of the study. The women in the control group gained an average of 3 pounds overall.

The authors found that only 9 percent of the women in the special program group had large-for-gestational-age babies, versus 26 percent of the women in the control group.

Large-for-gestational-age, or LGA, babies typically grow too fast during pregnancy — sometimes resulting in birthing complications — and are born weighing more than 90 percent of babies. LGA babies have a higher risk of becoming obese later in life.

According to Dr. Erwin, women and their doctors should use body mass index (BMI) to determine if they are underweight, normal weight, overweight or obese. BMI is a measure of body based on height and weight.

"For those women starting pregnancy at a normal weight (BMI 18.5-24.9), weight gain should be 25-35 pounds," Dr. Erwin explained. "For overweight women (BMI 25.0-29.9), weight gain should be 15-25 pounds for the entire pregnancy. For obese women (BMI >30) weight gain should only be 11-20 pounds total."

Dr. Vesco and team wrote that the Institute of Medicine suggests that obese women gain between 11 and 20 pounds while they are pregnant.

"Most women in our intervention did gain some weight, but they gained and retained significantly less than women who did not participate in the intervention," Dr. Vesco said in a press release. "Even with support, it's difficult to limit weight gain during pregnancy, so women who are overweight or obese should aim for the lower end of the weight-gain range recommended by the Institute of Medicine, and they should seek support and nutritional advice to help meet their goals."

Most of the women in the study were white, from one region of the country, and insured and had access to prenatal care, so the findings may not apply to other populations.

This study was published Aug. 28 in Obesity.

The National Institute of Child Health and Human Development funded the study. The authors disclosed no conflicts of interest.

Review Date: 
August 28, 2014