How Much of Weight Gain During Pregancy Is Baby
Number 548 (Reaffirmed 2020)
Committee on Obstetric Practice
This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed equally dictating an exclusive class of handling or procedure to be followed.
ABSTRACT: The updated guidelines by the Constitute of Medicine regarding gestational weight gain provide clinicians with a basis for practice. Health care providers who treat significant women should determine a adult female'south body mass alphabetize at the initial prenatal visit and counsel her regarding the benefits of appropriate weight gain, nutrition and do, and, especially, the need to limit excessive weight gain to reach best pregnancy outcomes. Individualized care and clinical judgment are necessary in the management of the overweight or obese woman who is gaining (or wishes to gain) less weight than recommended just has an accordingly growing fetus.
The amount of weight gained during pregnancy tin touch on the immediate and hereafter health of a woman and her baby. The population demographics of women who go pregnant accept changed dramatically over the past decade; more women are overweight or obese at conception. Evidence supports associations betwixt excessive gestational weight gain and increased birth weight and postpartum weight retention but too betwixt inadequate weight gain and decreased nascence weight 1. Gestational weight gain recommendations aim to optimize outcomes for the woman and the infant. In 2009, the Constitute of Medicine (IOM) published revised gestational weight gain guidelines that are based on prepregnancy trunk mass index (BMI) ranges for underweight, normal weight, overweight, and obese women recommended by the World Health System and are independent of historic period, parity, smoking history, race, and indigenous background Table 1 2. Other changes include the removal of the previous recommendations for special populations and the addition of weight gain guidelines for women with twin gestations. For twin pregnancy, the IOM recommends a gestational weight gain of xvi.8–24.5 kg (37–54 lb) for women of normal weight, 14.1–22.seven kg (31–50 lb) for overweight women, and xi.3–19.one kg (25–42 lb) for obese women. The IOM guidelines recognize that data are insufficient to decide the corporeality of weight women with multifetal (triplet and higher lodge) gestations should gain.
The updated IOM recommendations have met with controversial reactions from some physicians who believe that the weight proceeds targets are too loftier, peculiarly for overweight and obese women. Also, these perceived high weight gain targets practise non address concerns regarding postpartum weight retentivity. In addition, concerns accept been raised that the guidelines do not differentiate degrees of obesity, especially for morbidly obese women.
Overweight Women
The IOM guidelines recommend a total weight gain of six.8–11.three kg (15–25 lb) for overweight women (BMI of 25–29.9; BMI is calculated as weight in kilograms divided by top in meters squared). Gestational weight gain below the IOM recommendations among overweight meaning women does not appear to have a negative outcome on fetal growth or neonatal outcomes. In several studies, overweight women who gained two.vii–6.4 kg (6–14 lb) had similar fetal growth, perinatal and neonatal outcomes, and less postpartum weight memory equally overweight women who gained weight inside the currently recommended IOM range iii 4 5 6 seven viii. For the overweight pregnant woman who is gaining less than the recommended corporeality merely has an appropriately growing fetus, no evidence exists that encouraging increased weight gain to suit with the current IOM guidelines will improve maternal or fetal outcomes.
Obese Women
The IOM recommendations ascertain obesity every bit a BMI of 30 or greater and do not differentiate between Course I obesity (BMI of thirty–34.9), Grade II obesity (BMI of 35–39.9), and Class Three obesity (BMI of 40 or greater) 2. Given the limited data past class, the IOM recommendation for weight gain is 5–9.1 kg (eleven–twenty lb) for all obese women. The gestational weight proceeds guidelines attempt to balance the risks of having large-for-gestational-historic period infants, small-for-gestational-age infants, and preterm births and postpartum weight retention. Citing a lack of sufficient data regarding brusk-term and long-term maternal and newborn outcomes, authors of the IOM report did not recommend lower targets for women with more than astringent degrees of obesity 9. The results of observational studies continue to provide mixed results.
The results of several large population-based cohort studies published after the release of the IOM guidelines suggested no impairment in setting more restrictive weight gain limitations viii x. I systematic review establish that overweight and obese women who proceeds less weight than the ranges recommended past the IOM do not have an increased risk of having a low nascence weight baby 1. Conversely, other researchers have reported that even the IOM guidelines may exist too restrictive for severely obese women and may be associated with increased rates of preterm births, minor-for-gestational-age infants, and perinatal bloodshed when compared with women with a like BMI who gain an average corporeality of weight during pregnancy 11. From the results of these and more than recent studies, information technology appears that the relationships between maternal obesity class, gestational weight gain, and maternal and newborn outcomes are complex.
Amidst severely obese women with weight loss or restricted weight gain during pregnancy, the possible gamble of having minor-for-gestational-age infants contrasts with possible benefits, such as a decrease in rates of cesarean delivery, a risk of having large-for-gestational-age infants, and postpartum weight retentivity 10 12 13. For an obese pregnant woman who is gaining less weight than recommended but has an appropriately growing fetus, no testify exists that encouraging increased weight gain to conform with the updated IOM guidelines will improve maternal or fetal outcomes. For more data, meet the American Higher of Obstetricians and Gynecologists' Commission Stance No. 549, "Obesity in Pregnancy" xiv.
Conclusions and Recommendations
The IOM gestational weight proceeds guidelines provide clinicians with a ground for practise. Wellness care providers who intendance for significant women should determine a adult female's BMI at the initial prenatal visit (an online BMI computer is bachelor at http://www.nhlbisupport.com/bmi. It is important to talk over appropriate weight proceeds, diet, and do at the initial visit and periodically throughout the pregnancy. Individualized intendance and clinical judgment are necessary in the management of the overweight or obese adult female who is gaining (or wishes to gain) less weight than recommended but has an appropriately growing fetus. Balancing the risks of fetal growth (in the large-for-gestational-age fetus and the small-for-gestational-age fetus), obstetric complications, and maternal weight retentiveness is essential simply will remain challenging until research provides evidence to further refine the recommendations for gestational weight gain, especially among women with high degrees of obesity.
Copyright January 2013 by the American College of Obstetricians and Gynecologists, 409 12th Street, SW, PO Box 96920, Washington, DC 20090-6920. All rights reserved.
ISSN 1074-861X
Weight gain during pregnancy. Committee Opinion No. 548. American Higher of Obstetricians and Gynecologists. Obstet Gynecol 2013;121:210–2.
Source: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/01/weight-gain-during-pregnancy
0 Response to "How Much of Weight Gain During Pregancy Is Baby"
Post a Comment