Women who gain more weight than they recommended during pregnancy may increase their chances of serious complications at delivery, a study of more than a half-million births in New York City suggests.
In particular, Researchers report in Obstetrics & Gynecology that women who achieved more than 20 pounds above the guideline levels had significantly higher rates of heart failure, severe high blood pressure and need transfusion or ventilation.
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"We've seen a huge surge in. . . Maternal mortality in this country, and when we look at the risk factors that are potentially modifiable, gestational weight gain is one that can change throughout pregnancy, "said lead author Dr. Marissa Platner of Emory Healthcare and the Emory School of Medicine in Atlanta, Georgia.
In 2009, the National Academy of Medicine's revised guidelines for weight gain during pregnancy based on the pre-pregnancy BMI, a ratio of weight to height.
Women in the normal BMI range of 18.5-24.9 are encouraged to gain 25 to 35 pounds during pregnancy. Those with a BMI below 18.5 should gain 28 to 40 pounds. Women who are overweight before becoming pregnant should get less during pregnancy: 15 to 25 pounds for those with BMI between 25 and 29.9 and just 11 to 20 pounds for those with BMI of 30 or higher.
Nearly half of all pregnant women women in the US
"It's really important to optimize your nutrition, diet and exercise before you become pregnant and then during the pregnancy," Platner said in the a phone interview. "It's one of the most important things you can do to affect your pregnancy outcomes."
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For the new study, researchers analyzed 515,148 singleton births using 2008-2012 in New York City
About one quarter of the women gained less than the recommended dose, which included information on pre-pregnancy weight and gestational weight gain, as well as serious delivery-related complications such as life-threatening diagnoses, life-saving procedures, or death. one third gained in the recommended range, another third gained 1-19 pounds more than recommended and 8 percent gained more than 20 pounds above the guideline for their pre-pregnancy BMI.
Overall, the two groups with weight gain over the guideline have had higher rates of complications at delivery. For example, these women were almost four times more likely to experience heart failure during the procedure, and about two and a half times more likely to require ventilation.
"We saw the increase affect women across the spectrum for all pre-pregnancy weights, "Platner said. "
Women whose pre-pregnancy BMI was."
Women whose pre-pregnancy BMI was below normal had the highest risk with weight gain above the guideline range.
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Women and their doctors need to know about these guidelines for weight gain during pregnancy, said Dr. Michelle Kominiarek, a maternal-fetal medicine specialist with Northwestern Medicine in Chicago,
"A discussion of weight gain goals and methods for achieving these goals should be a priority for providers to have with their Patients, "she said by email.
Platner and her team are researching the best ways to talk to women about diet and exercise during pregnancy. For example, a healthy increase in calorie intake is about 250 per day, she said.
"A healthy diet helps both the mother and the baby," said Dr. Sarl Lisonkova of the University of British Columbia in Vancouver, who was not involved in the study.
"Pregnancy is a great motivating factor to start or continue a healthy lifestyle, including well-balanced diet with plenty of fruits and vegetables. , "Lisonkova said by email. "This lifestyle should continue beyond pregnancy."