perinal


"Maternal obesity establishes a suboptimal intrauterine environment, which ultimately contributes to the development of childhood obesity, type II diabetes, and metabolic syndrome."
-Schmatz et al. (2010)

Weight Management: Pregnancy and Postpartum
The Challenges

The American Medical Association declared obesity a disease in 2013. Currently, 33.8% of the US population is obese, while another 34% are overweight. Obesity increases a person’s risk for heart disease, stroke, type 2 diabetes, and certain types of cancer.

The Cycle of Obesity
Approximately half of all reproductive-age women in the U.S. are overweight or obese. This tells us that many women are entering into pregnancy at an unhealthy weight. Just over half of pregnant women are also gaining more than the recommended amount of weight during pregnancy.

Pregnant women who are obese are at an increased risk of:

  • Excessive gestational weight gain (GWG)
  • Hypertensive disorders
    • Gestational hypertension
    • Pre-eclampsia - Can lead to maternal organ damage, maternal seizures (eclampsia), low birth weight, premature birth, and still-birth
  • Gestational Diabetes
  • Preterm Delivery

This is not just a health issue for moms or expectant mothers. Recent studies suggest that there are long-term effects of maternal obesity and excessive gestational weight gain on the baby as well. Excessive weight gain in pregnancy increases risk of childhood obesity, which increases risk of obesity in adolescence and adulthood.

Approximately 60% of pregnant women in the U.S. don’t gain the appropriate amount of weight as recommended by the Institutes of Medicine (IOM) based on their pre-pregnancy BMI.

The IOM guidelines were revised in 2009 and published in the report, Weight Gain During Pregnancy: Reexamining the Guidelines. This report reexamined the guidelines published in 1990. The IOM report (2009) indicates that many practitioners were not aware of or did not follow the 1990 guidelines.

Here is a quick look at the differences between the 1990 and 2009:

  • The 1990 guidelines did not differentiate between overweight and obese; they recommended that all women with a BMI over 30.0 should gain 15-25 lbs during pregnancy.
  • In 2009, the guidelines were rewritten to reflect the need to customize weight gain based on level of obesity ( overweight vs obese).
  • The new guidelines recommend a weight gain in the range of 15-25 lbs for overweight women and 11-20 lbs for obese women.

Many women are not aware of how much weight they should gain during pregnancy and many practitioners do not address the topic of weight during health visits. Clearly, with obesity being an epidemic, starting this conversation with patients is more important than ever.

Visit our Resources page to find helpful tools that will help start the conversation about healthy weight.

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