The convenience-store checkout counters have been weighed down with magazines depicting plump pregnant pop celebrities. With unflattering pictures as evidence, these women are accused of developing unhealthy food addictions and put on trial in the court of public opinion.
How much is too much weight gain during pregnancy? Can excess weight gain be unhealthy for mom and baby?
In the 1930s, women were advised to gain only 15 pounds during pregnancy. These strict standards may have led to infants with low birth weight and neurological disorders.
By 1987, the Committee on Nutritional Status During Pregnancy and Lactation of the Institute of Medicine updated guidelines. Those guidelines say women at normal weight should gain about 25 to 35 pounds during the course of a pregnancy. An overweight woman should gain between 15 and 25 pounds, and an obese woman should add only 11 to 20 pounds during her nine months of pregnancy. Morbidly obese women may need far less weight gain and need physician-guided strategies to promote healthier eating.
According to the American College of Obstetrics and Gynecology, the amount of weight gain during pregnancy can affect not just the immediate health of the woman and her baby but the future health of both as well. This is more important as more women today are overweight or obese prior to becoming pregnant.
What about Princess Kate, the Duchess of Cambridge? Prior to pregnancy, she was underweight (according to her body mass index of height and weight calculation). The OB/GYN guidelines say she should gain from 28 and 40 pounds, or 2 to 2.9 stone, as they say in Great Britain.
Most important, pregnant women should consume a healthy diet that transfers nutrient-rich foods to the growing baby. However, many readers will be surprised to know that pregnant women need only about 300 more calories per day compared with their nonpregnant diet. That is the equivalent of an extra 8-ounce low-fat blueberry smoothie a day.
One magazine includes a pop-culture celebrity saying, “I’ll eat as much as I want,” and subtitles include suggestions that this celebrity is ignoring “dire health warnings” related to her excessive pregnancy poundage. If she is gaining excessive weight, she should be concerned.
Being obese during pregnancy could increase the risk of many complications including (gestational) diabetes. According to the Centers for Disease Control, between 7 percent and 18 percent of pregnancies in the United States are affected by this disease, and mothers will have up to a 60 percent chance of developing diabetes within 20 years after pregnancy.
According to a January 2011 National Institutes of Health study, obesity increases the risk of high blood pressure (pre-eclampsia) to three times that of normal-weight pregnancies. Excessively high blood pressures in pregnant women can result in poor placental blood flow to the baby and high risks of hemorrhage. It is a significant cause of infant and maternal mortality.
Obesity with pregnancy also increases the risk of labor problems leading to more Caesarean sections. Delayed surgical healing is another complication. I have packed wounds in obese women in the hospital postpartum wards. These poor women were new to motherhood and unable to care for their infants as they could barely sit up or tend to their own wounds without assistance.
Obesity with pregnancy also puts infants at higher risk for macrosomia (larger size than average birth weight). Large babies have difficulty regulating body temperature and blood sugars immediately after birth and require extra attention. If blood sugars drop too much, the baby could suffer significant brain injury.
Some studies suggest that as birth weight increases, so does the risk of childhood obesity that could pose a higher risk for heart disease or diabetes in adulthood. Obesity during pregnancy increases the risk of having a baby with birth defects such as heart, brain or spinal-cord disorders.
Weigh your options prior to pregnancy. Choose healthy lifestyles before becoming pregnant and maintain those choices throughout pregnancy. Pregnancy is not a free ride to an all-day stay at your local fast-food joint. It is a time to critically consider the nutritional selections of everything that goes into your body. Because what goes in does not always come out (as they say); what you do eat can be, instead, an investment in your baby’s health.