How Many Pounds Should a Person of Average Weight Gain During Their Pregnancy for a Single Baby?
Number 548 (Reaffirmed 2020)
Committee on Obstetric Practice
This document reflects emerging clinical and scientific advances equally of the appointment issued and is subject to change. The information should non exist construed as dictating an exclusive course of treatment or process to be followed.
Abstract: The updated guidelines by the Institute of Medicine regarding gestational weight gain provide clinicians with a footing for practice. Health care providers who care for pregnant women should decide a woman'southward body mass index at the initial prenatal visit and counsel her regarding the benefits of advisable weight gain, nutrition and exercise, and, especially, the demand to limit excessive weight gain to achieve 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 but has an appropriately growing fetus.
The amount of weight gained during pregnancy can affect the immediate and future wellness of a adult female and her babe. The population demographics of women who become pregnant have changed dramatically over the past decade; more women are overweight or obese at conception. Bear witness supports associations between excessive gestational weight gain and increased birth weight and postpartum weight retention just also betwixt inadequate weight proceeds and decreased birth weight 1. Gestational weight proceeds recommendations aim to optimize outcomes for the woman and the babe. In 2009, the Plant of Medicine (IOM) published revised gestational weight proceeds guidelines that are based on prepregnancy torso mass index (BMI) ranges for underweight, normal weight, overweight, and obese women recommended by the World Health Organization and are independent of age, parity, smoking history, race, and indigenous groundwork Table one 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 16.eight–24.5 kg (37–54 lb) for women of normal weight, 14.1–22.7 kg (31–50 lb) for overweight women, and xi.three–19.one kg (25–42 lb) for obese women. The IOM guidelines recognize that information are insufficient to determine the amount of weight women with multifetal (triplet and college order) gestations should gain.
The updated IOM recommendations have met with controversial reactions from some physicians who believe that the weight gain targets are too loftier, especially for overweight and obese women. Also, these perceived loftier weight proceeds targets do not address concerns regarding postpartum weight retention. In add-on, concerns have been raised that the guidelines do not differentiate degrees of obesity, specially for morbidly obese women.
Overweight Women
The IOM guidelines recommend a total weight proceeds of 6.8–11.iii kg (fifteen–25 lb) for overweight women (BMI of 25–29.9; BMI is calculated every bit weight in kilograms divided past peak in meters squared). Gestational weight gain below the IOM recommendations amongst overweight pregnant women does not announced to have a negative effect on fetal growth or neonatal outcomes. In several studies, overweight women who gained 2.7–6.4 kg (6–14 lb) had like fetal growth, perinatal and neonatal outcomes, and less postpartum weight retention as overweight women who gained weight within the currently recommended IOM range 3 four five six 7 8. For the overweight meaning woman who is gaining less than the recommended amount but has an accordingly growing fetus, no prove exists that encouraging increased weight proceeds to conform with the current IOM guidelines will improve maternal or fetal outcomes.
Obese Women
The IOM recommendations ascertain obesity equally a BMI of 30 or greater and do non differentiate between Class I obesity (BMI of thirty–34.9), Class II obesity (BMI of 35–39.9), and Grade Iii obesity (BMI of 40 or greater) 2. Given the limited data by class, the IOM recommendation for weight gain is 5–9.one kg (xi–20 lb) for all obese women. The gestational weight gain guidelines attempt to balance the risks of having large-for-gestational-historic period infants, small-for-gestational-historic period infants, and preterm births and postpartum weight retentivity. Citing a lack of sufficient information regarding curt-term and long-term maternal and newborn outcomes, authors of the IOM report did non recommend lower targets for women with more than astringent degrees of obesity 9. The results of observational studies go along to provide mixed results.
The results of several large population-based cohort studies published afterwards the release of the IOM guidelines suggested no harm in setting more restrictive weight gain limitations viii x. One systematic review constitute that overweight and obese women who proceeds less weight than the ranges recommended past the IOM do not accept an increased take a chance of having a low nascency weight infant 1. Conversely, other researchers have reported that even the IOM guidelines may be too restrictive for severely obese women and may be associated with increased rates of preterm births, modest-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 recent studies, it 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 proceeds during pregnancy, the possible take a chance of having pocket-sized-for-gestational-historic period 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 memory 10 12 xiii. For an obese meaning adult female who is gaining less weight than recommended but has an accordingly growing fetus, no evidence exists that encouraging increased weight gain to conform with the updated IOM guidelines will better maternal or fetal outcomes. For more data, see the American Higher of Obstetricians and Gynecologists' Committee Stance No. 549, "Obesity in Pregnancy" xiv.
Conclusions and Recommendations
The IOM gestational weight gain guidelines provide clinicians with a basis for practise. Health care providers who intendance for meaning women should determine a woman's BMI at the initial prenatal visit (an online BMI calculator is available at http://www.nhlbisupport.com/bmi. Information technology is important to discuss appropriate weight gain, diet, and exercise at the initial visit and periodically throughout the pregnancy. Individualized care 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 but will remain challenging until research provides evidence to farther refine the recommendations for gestational weight gain, peculiarly among women with loftier degrees of obesity.
Copyright Jan 2013 by the American College of Obstetricians and Gynecologists, 409 twelfth 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–ii.
Source: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/01/weight-gain-during-pregnancy
0 Response to "How Many Pounds Should a Person of Average Weight Gain During Their Pregnancy for a Single Baby?"
Post a Comment