February 24, 2015
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Pregnant women with obesity should limit weight gain until mid-pregnancy

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Pregnant women with various classes of obesity based on BMI should not gain any weight until at least mid-pregnancy, according to study findings published in Obesity.

“Research shows that pregnant women with obesity are at increased risk of pregnancy complications, including gestational diabetes mellitus, hypertension, preeclampsia, cesarean delivery and postpartum weight retention,” Jennifer A. Hutcheon, PhD, of the University of British Columbia in Vancouver, Canada, said in a press release. “Similarly, children born to pregnant women with obesity face higher risks of prematurity, stillbirth, congenital anomalies, macrosomia with possible birth injury and childhood obesity. These known risks reinforce the need to closely monitor weight gain during pregnancy for women with obesity, which reduces risks and can lead to better outcomes.”

Jennifer A. Hutcheon

Jennifer A. Hutcheon

Hutcheon and colleagues evaluated data from 1,047 women with overweight (pre-pregnancy BMI, 25-29.9 kg/m2), 1,202 with class I obesity (pre-pregnancy BMI, 30-34.9 kg/m2), 1,267 with class II obesity (pre-pregnancy BMI 35-39.9 kg/m2) and 730 with class III obesity (pre-pregnancy, BMI ≥ 40 kg/m2) — all with uncomplicated pregnancies — to build charts for pregnancy weight gain-for-gestational age z score.

“Monitoring weight gain during pregnancy is key for optimal outcomes, and this is the first time we’ve had a glimpse of reference points for women with class II and class III obesity,” Hutcheon said in the release. “With these data, we are a step closer to developing a more comprehensive understanding of safe and healthy levels of weight gain for women with different classes of obesity during pregnancy.”

Median weight gain was minimal among participants with overweight until 15 weeks, increasing in a linear manner until term. Median weight gain remained minimal for longer among participants with more obesity, and there was a decrease in rate of weight gain.

Researchers used the mean, standard deviation and select percentiles for all pregnancies to create the charts.

“The creation of these charts is a critical step in obtaining high-quality evidence on the relationship between gestational weight gain and stillbirth, infant death, and preterm term in severely obese women,” the researchers wrote. “Further, once studies have identified the gestational weight gain z scores associated with optimal pregnancy outcomes, women and their health care providers can use these charts in antenatal care to monitor the progress of weight gain and to prompt discussion on the need to intervene.” – by Amber Cox

Disclosure: The researchers report no relevant financial disclosures.