A global study published last month reveals that approximately 75% of pregnant women are experiencing unhealthy weight gain.1 The study, which combines data from Asia, the United States, and Europe shows that half of women gain too much weight during pregnancy and almost a quarter fail to gain enough, increasing the risk of premature birth and c-sections. Gestational diabetes is also correlated with excessive weight gain during pregnancy.
BMI Guidelines
The study analyzed over 5,000 previous studies across the 3 countries and found, in addition to the above statistics, that 7% of women actually enter into pregnancy underweight, and 38% begin their pregnancy overweight. Though not always ideal measurements of “healthy weight,” the BMI guidelines in this regard are: Underweight – less than 18.5; normal weight – 18.5 – 24.9; overweight 25 – 29.9.
ACOG Recommendations
The corresponding recommendations of the American College of Obstetricians and Gynecologists (ACOG), pregnant women should gain 28-40 lbs of total weight gain for underweight women, 25-35 lbs for healthy weight women, and 15-25 lbs for overweight women. Obese women, should aim for a total weight gain of 11-20 lbs.2
Rate of Weight
The rate of weight gain is also important, with most of the weight being accumulated as the rapidity of fetal growth increases in the second and third trimester. The first trimester may have minimal weight gain, up to 4.5 lbs, but the second and third trimester recommendations for weight gain are around 1 lb per week for underweight and healthy weight mothers, and around 0.5 lb per week weight gain for overweight individuals.2
Gestational Weight and Birth Defects
Gestational weight gain under or over the recommendations were associated with greater numbers of adverse birth events, including cesareans, low birth weight, premature birth, and birth complications. This study advocates simple lifestyle interventions to promote and encourage healthy weight gain during pregnancy, and outlines that these interventions need to be made available to mothers and their care teams. This is a great supporting meta-analysis for the naturopathic involvement in maternity care.
Sources:
- Goldstein RF, Abell SK, Ranasinha S, et al. Association of Gestational Weight Gain With Maternal and Infant Outcomes: A Systematic Review and Meta-analysis. JAMA. 2017;317(21):2207-2225.
- Weight gain during pregnancy. Committee Opinion No. 548. American College of Obstetricians and Gynecologists. Obstet Gynecol 2013;121:210–2.
Node Smith, associate editor for NDNR, is a fifth year naturopathic medical student at NUNM, where he has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine amongst the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend campout where naturopathic medicine and medical philosophy are experienced in nature. Three years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.
