Appropriate weight gain in pregnancy

Appropriate weight gain in pregnancy

Appropriate weight gain in pregnancy


Dr Himabindu Annamraju, Senior Consultant - Obstetrician, Gynaecologist & Laparoscopic surgeon, Specialist in High-Risk Pregnancy, Birth right at Rainbow Hospitals, Hyderabad, talks about the risk of weight gain during pregnancy

Weight gain in pregnancy is expected, but it can be quite variable. The weight gain in pregnancy is due to the growth of the baby, but also due to the maternal body depositing fat. Putting on too much weight or too little weight can lead to health problems for the pregnant woman as well as the baby.

Women who put on too much weight during pregnancy are at risk of developing BP problems (like pre-eclampsia) and diabetes in pregnancy (called gestational diabetes). These women are at a higher risk of having an induction of labour, emergency caesarean section, at risk of having complications during the birth, anaesthetic complications, and wound infections. They are also at risk of having blood clots in their legs or lungs.

Women who put on too little weight during the pregnancy are at risk of a small baby or growth-restricted baby, and at risk of having preterm delivery.

To understand appropriate weight gain in pregnancy, it is important to know your BMI. BMI or Body Mass Index is calculated in kg/m2, as seen below:

BMI= measuring your weight in kg (height in metres)

This can be easily calculated using online tools. Normal BMI is considered to be between 18.5 and 24.9. The table below lists the Institute of Medicine’s (IOM)’ guidelines for weight gain in pregnancy. These gestational weight gain guidelines attempt to balance the risks of having large-for-gestational-age infants, small-for-gestational-age infants, preterm births, and postpartum weight retention.

The recommended weight gain in pregnancy varies depending on the woman’s BMI pre-pregnancy or early pregnancy. Women who are underweight and have a low BMI in early pregnancy are advised to put on 12.5kg-18kg, throughout the pregnancy. For a woman who has a normal BMI (18.5-24.9) in early pregnancy, the recommended weight gain is 11.5kg-16kg. Women who are overweight with an initial BMI of 25-30, are advised to limit their weight gain to under 11.5kg, for the pregnancy. For obese women who have a high BMI over 30 in early pregnancy, we advise them to try and maintain their weight stable and have no more than 5-9 kg weight gain in the pregnancy.

Dieting during pregnancy is not recommended. Women should be encouraged to optimise their BMI before pregnancy. During pregnancy, women should be advised to lead an active lifestyle, follow healthy eating habits, and monitor their weight regularly. If the woman has not previously exercised routinely, she should begin with about 15 minutes of continuous exercise, three times per week, increasing gradually to 30-minute sessions every day. Some examples of healthy exercise include swimming, walking, and pregnancy yoga. A healthy diet is strongly recommended in pregnancy, especially if the BMI is above normal. A carefully planned diet, under the guidance of a dietician, would be advisable.

An increasing number of very obese women are choosing to undergo bariatric surgery (weight loss surgery), before contemplating pregnancy. For these women, after surgery, their hormonal balance improves, they start ovulating regularly and they get a boost in their fertility. It is best advisable for them to wait for at least 12-24 months after the surgery, until their weight stabilises, before planning conception. After any bariatric surgery, the body doesn’t digest food and absorb nutrients the same way it used to. So, the patients need to take supplemental vitamins and minerals for life to avoid severe medical problems due to low vitamin and mineral levels. Nutritional deficiencies seen in pregnancy for these groups of women include protein, B12, iron, folate, calcium, and vitamin D. After all the effort they have put in to lose weight, it is difficult for these women to gain weight during pregnancy. It is essential for these women to be taken care of, by expert obstetricians who have the necessary knowledge and experience along with nutritional specialists, to ensure the best outcomes for the mother and the baby.

In essence, it is a myth that the pregnant woman must ‘eat for two’. It is prudent to discuss with your obstetrician and have a diet plan tailored for you and your pregnancy.

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