Achieving a Healthy Weight Gain During Pregnancy

Division of Nutritional Sciences, Cornell University, Ithaca, New York 14853, USA.
Annual Review of Nutrition (Impact Factor: 8.36). 03/2008; 28(1):411-23. DOI: 10.1146/annurev.nutr.28.061807.155322
Source: PubMed


This review uses the 1990 U.S. Institute of Medicine (IOM) gestational weight gain recommendations to examine the question, what is a healthy pregnancy weight gain? The relationship of gestational weight gain to infant size at birth; pregnancy, labor, and delivery complications; neonatal, infant, and child outcomes; and maternal weight and health outcomes in U.S. and European populations are discussed. Pregnancy weight gains within the IOM recommendations are associated with better outcomes. The possible exception is very obese women, who may benefit from weight gains less than the 7 kg (15 pounds) recommended. Only about 33% to 40% of U.S. women gain within IOM recommendations. Excessive gestational weight gain is more prevalent than inadequate gain. Women's gestational weight gains tend to follow the recommendations of health care providers. Current interventions demonstrate efficacy in influencing gestational weight gain in low-income women with normal and overweight body mass index in the United States and obese women in Scandinavia.

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    • "Approximately 75% of Non-Hispanic Black women and 50% of Non- Hispanic White women of childbearing age are overweight or obese (Flegal et al., 2012). The increasing trend in pre-pregnancy BMI seems to parallel the increasing trend of excessive gestational weight gain, with up to 50% of women exceeding the Institute of Medicine (IOM) weight gain guidelines during pregnancy (National Research Council and Institute of Medicine, 2007; Olson, 2008; Simas et al., 2011). Excessive gestational weight gain is associated with many adverse health outcomes, including an increased risk of gestational diabetes, preeclampsia, caesarean birth, macrosomia, and overweight or obesity in the mother (Guelinckx et al., 2008; Nehring et al., 2011; Hernandez, 2012). "
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    ABSTRACT: Objective: To describe African American and White women's perceptions of weight gain, physical activity, and nutrition during pregnancy and to explore differences in perceptions by race. Design: Qualitative interview study. Setting: Two Ob/Gyn clinics in South Carolina, USA. Participants: Thirty pregnant women (15 African American, 15 White) between 20 and 30 weeks gestation, equally represented across pre-pregnancy BMI categories (10 normal weight, 10 overweight, and 10 obese). Findings: White women more frequently described intentions to meet weight gain, physical activity, and dietary guidelines in pregnancy than African American women. African American women were more concerned with inadequate weight gain while White women more commonly expressed concerns about excessive weight gain. More White women discussed the importance of physical activity for weight management. Regardless of race, few women described risks of excessive weight gain or benefits of physical activity as it relates to the baby's health. The primary cited barrier of healthy eating was the high cost of fresh produce. Key conclusions and implications for practice: Several knowledge gaps as well as race differences were identified in women's perceptions and intentions toward weight gain, physical activity, and nutrition during pregnancy. Future interventions should seek to educate women about common misperceptions. It may be necessary to culturally tailor gestational weight gain interventions to optimise health outcomes.
    Full-text · Article · Nov 2015 · Midwifery
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    • "Weight gain, physical activity (PA), and dietary intake all directly influence pregnancy outcomes and the long-term health of mother and child. Only one-third of women meet the Institute of Medicine (IOM) weight gain guidelines during pregnancy, with up to 50 % gaining excessive weight (Institute of Medicine, 2007; Olson, 2008; Simas et al., 2011). Pregnancy weight gain above recommendations is associated with many adverse health outcomes, including an increased risk of gestational diabetes, preeclampsia, cesarean delivery, macrosomia, and new or persistent overweight or obesity in the mother (Guelinckx et al., 2008; Hernandez, 2012; Nehring et al., 2011). "
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    ABSTRACT: A better understanding of women's perceptions of weight gain and related behaviors during pregnancy is necessary to inform behavioral interventions. We used the Theory of Planned Behavior (TPB) to examine pregnant women's perceptions and intentions toward weight gain, physical activity (PA), and nutrition using a mixed methods study design. Women between 20 and 30 weeks gestation (n = 189) were recruited to complete an Internet-based survey. Salient beliefs toward weight gain, PA, and nutrition were captured through open-ended responses and content analyzed into themes. TPB constructs (attitude, subjective norm, perceived behavioral control, intentions) were examined using Pearson correlations and hierarchical linear regression models. Salient beliefs were consistent with the existing literature in non-pregnant populations, with the addition of many pregnancy-specific beliefs. TPB constructs accounted for 23-39 % of the variance in weight gain, PA, and nutrition intentions, and made varying contributions across outcomes. The TPB is a useful framework for examining women's weight-related intentions during pregnancy. Study implications for intervention development are discussed.
    Full-text · Article · Sep 2015 · Journal of Behavioral Medicine
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    • "Women who gain excessive weight during pregnancy have an increased risk of post partum obesity and retention of gestational weight gain (GWG) post birth. The latter has been shown to be a strong predictor of maternal overweight and obesity in the ensuing decade (Olson, 2008; Siega-Riz et al., 2009). Pregnant women are at risk of elevated depressive and anxiety symptoms with prevalence estimates ranging from 11.4% at 18 weeks gestation to 13.1% at 32 weeks gestation for antenatal depression and 14.6% at 18 weeks gestation to 15.6% at 32 weeks gestation for anxiety (Heron et al., 2004). "
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    ABSTRACT: Objective This study investigated the prospective relationships between mental health symptoms (depressive and anxiety symptoms) and body mass index (BMI) in women with and without excessive weight gain during pregnancy. The secondary aim was to examine whether mental health symptoms and BMI were predictive of one another. Two models were tested: the first depicted depressive or anxiety symptoms predicting BMI, and the second model depicted BMI predicting depressive or anxiety symptoms. Design and participants Women completed questionnaires at three time points throughout pregnancy, which comprised of the Depression, Anxiety and Stress Scale-21 and self-reported weight. Height and weight were also reported retrospectively at T1 to calculate pre-pregancy BMI category. To calculate total gestational weight gain (GWG), pre-pregnancy weight was substracted from weight at 36 weeks gestation. Methods 183 women were tracked during pregnancy; Time (T)1 (mean=16.50 weeks of gestation, SD=.92), T2 (mean=24.40 weeks of gestation, SD=.92), and T3 (mean=32.61 weeks gestation, SD=.88). The sample was divided into those for whom weight gain exceeded the guidelines for GWG (excessive gestational weight gain; EGWG), and those who for whom it did not. Multi-group path analyses compared the longitudinal relationships between depressive or anxiety symptoms and BMI during pregnancy for women with and without EGWG. Findings BMI did not predict depressive or anxiety symptoms. Depressive symptoms at T1, did however predict higher BMI at T2 for women without EGWG. Anxiety symptoms and BMI were not related, regardless of GWG status. Conclusion These findings suggest that depressive symptoms may precede increased BMI during pregnancy in women who do not gain weight excessively. There may be longitudinal relationships between depressive symptoms and BMI during pregnancy; however, further research is required to identify the mechanisms that link these health outcomes and inform the focus of intervention design.
    Full-text · Article · Dec 2014 · Midwifery
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