Too much or too little weight gain poses risks to pregnant mothers, babies

Women who gain more or less than recommended amounts of weight during pregnancy are likely to increase the risk of problems for both themselves and their child, according to a new report by the RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center.

The report, which was supported by the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) in partnership with the American Dietetic Association, is based on a systematic review of 150 studies that assessed the short- and long-term effects of maternal weight gain on pregnancy, mothers, fetuses, and children. The studies were published in English between January 1990 and October 2007.

Among the report’s key findings is a strong association between high maternal weight gain and increased fetal growth and infant birth weight, which can contribute to complications during labor if a baby is too big, and can lead to long term health effects for the child. High maternal weight gain also is associated with cesarean delivery and weight retention by mothers after childbirth.

The review also confirmed that gaining too little weight during pregnancy can be a problem. Low maternal weight gain is associated with poor fetal growth, lower birth weight, and the chance of a baby being born prematurely.

The report was prompted by several trends, including an increase in the number of American women who are overweight and obese, as well as the number who gain more weight during pregnancy than amounts laid out in the Institute of Medicine’s 1990 recommendations for maternal weight gain. Public health officials also are concerned about an increase in pregnancy complications such as diabetes and cesarean delivery.

The Institute of Medicine is currently reviewing its pregnancy weight guidelines to see if they need to be revised; it expects to issue a report next summer.

“Unfortunately, the existing body of research on maternal weight gain is inadequate to permit a more comprehensive assessment,” said Meera Viswanathan, Ph.D., the study director and a senior research analyst at RTI International. “Most beneficial would be an analysis that considers the risks and potential benefits of various maternal weight-gain scenarios to all women – irrespective of age, race or ethnicity, or their body mass index before they became pregnant. But such an analysis is not possible at this time.”

Her research colleague at UNC, Anna Maria Siega-Riz, Ph.D., agreed.

“Despite the large body of research, clear clinical recommendations based on this systematic review will be challenging to formulate because of major shortcomings in this research,” said Siega-Riz, an associate professor in the UNC School of Public Health’s epidemiology and nutrition departments. “To fully understand the effects of maternal weight gain on short- and long-term health outcomes for both women and infants, future studies will need to adopt standard measures and consistent definitions of exposures and outcomes.”

The researchers said future studies will need to examine multiple outcomes within the same study population to explore fully the trade-offs between the risks and benefits to the mother and to the child.

Source: University of North Carolina at Chapel Hill

Related stories:

Less sleep, more TV leads to overweight infants and toddlers
Infants and toddlers who sleep less than 12 hours a day are twice as likely to become overweight by age 3 than children who sleep longer. In addition, high levels of television viewing combined with less sleep elevates the risk, so that children who sleep less than 12 hours and who view two or more hours of television per day have a 16 percent chance of becoming overweight by age 3.
Revise guidelines for weight gain during pregnancy, says obstetrician
Current recommendations for weight gain during pregnancy – developed by the Institute of Medicine (IOM) in 1990 – should be revised, according to an internationally recognized obesity expert and chairman of the department of obstetrics, gynecology and women’s health at Saint Louis University.
Mom's obesity during conception phase may set the stage for offspring's obesity risk
The number of overweight and obese Americans continues to grow rapidly. Today, 50 percent of adults are overweight and up to 20 percent are obese. While the number of overweight/obese children is at an all time high, the steady increase of overweight infants -- individuals under 11 months old -- is alarming.
Weight gain between first and second pregnancies associated with increased odds of male second child
A slightly greater number of males than females are born worldwide every year. In recent decades, although there are still more baby boys born than girls, there has been an apparent decline in the ratio of male to female newborns in several industrialized countries, including Canada, Denmark, England, Germany, Japan and the United States. That has led researchers to ask: Are there any factors that can influence the probability of giving birth to a baby boy or girl?
Weight gain in pregnancy linked to overweight in kids
Pregnant women who gain excessive or even appropriate weight, according to current guidelines, are four times more likely than women who gain inadequate weight to have a baby who becomes overweight in early childhood. These findings are from a new study at the Department of Ambulatory Care and Prevention of Harvard Medical School and Harvard Pilgrim Health Care and are published in the April issue of the American Journal of Obstetrics and Gynecology.
Kids follow unhealthy role models - parents
Fat teenagers rejoice, you can now blame your parents and the first five years of your life for your plumpness.
New Brisbane research proves fat parents are more likely to have fat children who will grow into fat teenagers if they don’t learn healthy living by age five.
The findings are the latest from the one of the world’s longest running health studies - the Mater-University of Queensland Study of Pregnancy.
About 3000 children in Brisbane had their body mass index (weight in kilograms divided by height in metres square) recorded at age five then at 14.
Looking for the Founatain of Youth? Cut your calories, research suggests
Want to slow the signs of aging and live longer? New Saint Louis University research suggests cutting back on calories could be a promising strategy.
Weight Watchers vs. fitness centers
In the first study of its kind, using sophisticated methods to measure body composition, the nationally known commercial weight loss program, Weight Watchers, was compared to gym membership programs to find out which method wins in the game of good health. A University of Missouri researcher examined the real-life experiences of participants to determine which program helps people lose pounds, reduce body fat and gain health benefits. The answer is that both have pros and cons and that a combination of the two produces the best results.

News discussion:

Medicine & Health news