Women who gain more weight during pregnancy than recommended may increase their chances of having serious delivery complications, as a study of more than half a million births in New York City suggests.
Women more than 20 pounds above the benchmarks had significantly higher heart failure, had high blood pressure, and needed transfusion or ventilation, report obstetrics and gynecology researchers.
"We have experienced a huge increase. , , Maternal mortality in this country, and if we look at the risk factors that are potentially modifiable, the weight gain may change during pregnancy, "said Dr. med. Marissa Platner, author of Emory Healthcare and the Emory School of Medicine in Atlanta. Georgia.
In 2009, the National Academy of Medicine revised the guidelines for weight gain during pregnancy based on the body mass index of pre-pregnancy women (BMI, a ratio of weight to height).
Women in the normal BMI range of 18.5-24.9 are required to gain 25 to 35 pounds during pregnancy. Those with a BMI under 18.5 should gain 28 to 40 pounds. Women who are overweight before pregnancy should gain less during pregnancy: 15 to 25 pounds for patients with a BMI between 25 and 29.9 and only 11 to 20 pounds for people with a BMI of 30 or higher.
Nearly half of all pregnant women in the US gain more than recommended, especially those who are overweight or obese before pregnancy, the authors state.
"It's very important to optimize your diet, your diet and your workout before you get pregnant and then during pregnancy. "Said Platner in a telephone interview. "This is one of the most important things you can do to influence your pregnancy outcomes."
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For the new study, the researchers analyzed 515,148 single births with New York City from 2008-2012 data providing information on the weight before pregnancy and the Weight gain in pregnancy, as well as serious complications in childbirth such as life-threatening diagnoses, life-saving procedures or deaths.
About a quarter of women gained less than recommended, one-third increased within the recommended range, another third gained 1 to 19 pounds more than recommended, and 8 percent gained more than 20 pounds over the BMI pre-pregnancy guideline.
Overall, the two groups with weight gains above the guideline range had higher complication rates at delivery. For example, these women were nearly four times more likely to develop heart failure during surgery, and about two and a half times more often ventilation was required.
"We have seen that women across the spectrum are affected for all pregnancies before pregnancy weights," said Platner. "Many doctors and women focus on gaining weight only in overweight or obese groups, but it is important that everyone talk about it, not just because they are thin before pregnancy."
Women whose BMI was below pre-pregnancy of the normal range were the highest risks with a weight gain above the guidelines range. Apart from weight gain in pregnancy outbreaks, the rates of major complications were highest in women with pre-pregnancy BMI in the adipose area.
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Women and their doctors need to know about these guidelines for weight gain during pregnancy, said Drs. Michelle Kominiarek, a maternal and fetal medicine specialist at Northwestern Medicine in Chicago who was not involved in the study.
"A discussion on weight gain goals and methods These goals should be a priority for care providers in their patients," she said by email.
Platner and her team are exploring the best ways to talk with women about diet and exercise during pregnancy. For example, a healthy increase in calorie intake is about 250 per day.
"A healthy diet benefits both the mother and the baby," said Drs. Sarka Lisonkova from the University of British Columbia at Vancouver was not involved in the study.
"Pregnancy is a great motivator to start or continue a healthy lifestyle, including a balanced diet rich in fruits and vegetables," Lisonkova said via email. "This lifestyle should last beyond the pregnancy."