Pregnancy is one of the most joyous times in a woman’s life. In just nine months the ultimate gift arrives — a newborn baby. In recent decades, research has been able to pinpoint issues during pregnancy that can complicate the future health of the unborn child. Many of these issues are linked to lifestyle behaviors. Early weight gain, especially when excessive, may be linked to a higher risk of childhood obesity.
Do you know the optimal amount of weight gain during pregnancy? The American Congress of Obstetrics and Gynecology (ACOG) issued updated weight gain guidelines in 2016 based on recommendations from the Institute of Medicine (IOM):
- If underweight at the time of pregnancy (BMI under 18.5) — 28-40 lbs. total (1 -1.3 lbs. per week in second and third trimester)
- If normal weight at the time of pregnancy (BMI 18.5-24.9) — 25-35 lbs. total (0.8 – 1 lb. per week in second and third trimester)
- If overweight at the time of pregnancy (BMI 25-29.9) — 15-25 lbs. (0.5-0.7 lb. per week in the second and third trimester)
- If obese at the time of pregnancy (BMI over 30) — 11 to 20 lbs. total (0.5 lb. per week in second and third trimester), though IOM also suggests a more restrictive weight gain in some cases
These guidelines were established because of increasing evidence that carrying too much weight during pregnancy is linked to a number of adverse outcomes for both mother and baby during the nine months, as well as during childbirth and afterward. Research has shown a link between excessive gestational weight gain and the risk of having a large baby, who is also at higher risk of obesity. Until now, there’s been little research to date about specific amounts of weight gain in the first trimester and the impact on the future health of the baby.
This new study analyzed 16, 218 mother-and-child “pairs” from Tianjin, China health data bases. It attempted to correlate a specific pattern or time frame of weight gain during pregnancy, with impact on baby size and future health. Specifically, it looked at “early in pregnancy weight gain,” (In this case regarded as the first and second trimesters) as well as third-trimester weight gain and the impact each had on infant size.
Regardless of pre-pregnancy BMI, excessive weight gain in the earlier part of pregnancy directly correlated with increased risk of a “large-for-gestational-age (LGA)” infant at birth. Excessive gestational weight gain in both early and late trimesters was associated with risk of having a large baby. It is worth mentioning that inadequate weight gain during the early trimesters (first and second) of pregnancy is associated with a higher risk of smaller-for-gestational-age (SGA) infant.
The message from this study is quite clear: Excess weight gain right at the beginning of a pregnancy can result in a large baby, and raise the risk that the child will develop obesity. That means a lifelong struggle with weight, and a heightened risk of developing: high blood pressure, high cholesterol, type 2 diabetes, sleep apnea and asthma, joint and musculoskeletal discomfort, fatty liver disease, gallstones, gastro-esophageal reflux, as well as social and psychological problems. Children diagnosed with obesity are at high risk of weight stigma.
If you are even considering starting a family, be proactive. Schedule a checkup with your primary care physician or OB-GYN and specifically discuss your weight. If you are carrying excess pounds, discuss strategies to help you shed pounds before you get pregnant, or at minimum, be clear on just how much weight is safe for you to gain during the pregnancy, given your current weight. You may find yourself motivated to embark on a lifestyle change program — including diet and exercise — because the health of your baby is at stake. Being overweight or having obesity can also interfere with your fertility, so there will be multiple benefits if you lose excess weight. Other healthy habits that you should consider before getting pregnant include:
- Stop the use of birth control pills or other forms of contraception (the Patch, NuvaRing, IUD).
- Get screened for sexually transmitted diseases
- Increase consumption of folic acid, which can prevent birth defects. Eat leafy greens, beans, citrus fruits, whole grains and folate-enriched breads, and cereals.
- Avoid thinking that because you are gaining weight “anyway,” it’s OK to have an unhealthy diet or eat in excess — this type of eating has health consequences.
- Start an exercise program to help you shed extra pounds and also help to prepare you for the physical challenges of delivery
- Stop smoking and limit or stop drinking alcoholic beverages
- Make sure your vaccinations are up-to-date
- If you have any health conditions like hypothyroidism, consult with your healthcare provider
- Go through your list of medications with your doctor to make sure that all are safe to take before and during pregnancy
- Have a dental checkup since gum disease appears to raise the risk of having an underweight or premature baby
- Have any sleep disorders treated since women with sleep disorders may be three times more likely to experience infertility compared to counterparts who don’t have this issue
- Consume low-mercury fish