Weight can be key for preg­nant and obese

Shed­ding pounds may be ben­e­fi­cial in some ways, per­haps not in oth­ers

Houston Chronicle Sunday - - HEALTH | SCIENCE - By Mari A. Schae­fer

Preg­nant women who are obese or over­weight are at an in­creased risk of com­pli­ca­tions, such as need­ing ce­sarean sec­tions, de­vel­op­ing ges­ta­tional di­a­betes and even the dan­ger­ous high blood pres­sure known as preeclamp­sia. Diet and ex­er­cise, re­searchers say, can help them safely con­trol their weight gain dur­ing preg­nancy. But there is a catch. The women in a re­cent study who lost weight — about 4 pounds on av­er­age — af­ter they were at least nine weeks into their preg­nan­cies did not have fewer ob­stet­ric com­pli­ca­tions. Re­searchers are con­clud­ing that to lower their risk of com­pli­ca­tions, women may have to change their be­hav­iors be­fore or im­me­di­ately af­ter they con­ceive.

“We think that by the time th­ese women are al­ready in the sec­ond trimester, it may al­ready be late to change im­por­tant out­comes,” said Alan Peace­man, lead au­thor and chief of ma­ter­nal fe­tal medicine at North­west­ern Univer­sity Fein­berg School of Medicine.

Seven clin­i­cal cen­ters in­clud­ing Brown and Columbia uni­ver­si­ties re­cruited 1,150 preg­nant women for the trial and split them into a con­trol group and an in­ter­ven­tion group. The sec­ond group fo­cused on re­duc­ing calo­ries, in­creas­ing phys­i­cal ac­tiv­ity and in­cor­po­rat­ing be­hav­ior changes such as self-mon­i­tor­ing. The trial, funded by the Na­tional In­sti­tutes of Health, fol­lowed par­tic­i­pants be­tween nine to 15 weeks preg­nant through the birth of their child.

The study was pub­lished last week in the jour­nal Obe­sity.

Most Amer­i­can women of child­bear­ing age are over­weight or obese. Th­ese women are more likely to gain ex­cess weight in preg­nancy, and to re­tain those pounds af­ter child­birth. Their chil­dren, too, are more likely to be obese than are the chil­dren of thin­ner women.

The Na­tional Academy of Medicine rec­om­mends that women who are not over­weight limit their preg­nancy weight gain to 25 to 35 pounds.

Women who are over­weight should gain no more than 15 to 25 pounds and obese women should not gain more than 11 to 20 pounds.

Ad­vice from doc­tors on weight gain dur­ing preg­nancy has var­ied over the years. In the 1950s, the stan­dard ad­vice was not to gain more than 15 pounds. But ex­pec­tant moth­ers weren’t gain­ing enough, and that led to low birth­weight ba­bies that were at higher risk for de­vel­op­men­tal prob­lems. By the late 1970s, moth­ers were told to “eat for two.”

When preg­nant women be­gan to gain more weight, the think­ing was that it was not a med­i­cal con­cern and they would be able to lose it af­ter they gave birth. But, by the early 2000s, doc­tors found the ex­tra pounds con­trib­uted to high blood pres­sure, ges­ta­tional di­a­betes and more ce­sarean sec­tions.

The in­fants also faced more risks.

“Ex­cess ma­ter­nal weight gain was not just associated with big­ger ba­bies, but those ba­bies ended up with an in­creased risk of obe­sity and child­hood di­a­betes,” Peace­man said.

Dream­stime / Tri­bune News Ser­vice

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.