Women who gain more weight than recommended during pregnancy can increase their chances of serious birth complications, suggests a study of more than half a million births in New York City.
In particular, women who gained more than 20 kilos compared to the indicated quantities had significantly higher rates of heart failure, severe hypertension and the need for transfusions or ventilation, the researchers report in Obstetrics and Gynecology.
THE GENES CAN BE BECAUSE SOME WOMEN HAVE THE CHECK OF BIRTH, STILL IN PREGNANCY
"We have seen a tremendous increase… Maternal mortality in this country, and when we look at the potentially modifiable risk factors, the gestational weight gain is what can change during pregnancy," he said. lead author Marissa Platner of Emory Healthcare and Emory School of Medicine in Atlanta, Georgia.
In 2009, the National Academy of Medicine revised the guidelines for weight gain during pregnancy based on women's pre-pregnancy body mass index (BMI, a relationship between weight and height).
Women in the normal BMI range of 18.5-24.9 are encouraged to earn 25 to 35 pounds during pregnancy. Those with a BMI of less than 18.5 should earn 28 to 40 pounds. Women who are overweight before starting a pregnancy should earn less during pregnancy: 15 to 25 pounds for those with a BMI between 25 and 29.9 and 11 to 20 pounds for those with a BMI of 30 or higher.
Almost half of all pregnant women in the United States earn more than recommended, however, particularly those who are overweight or obese before pregnancy, the authors note.
"It is very important to optimize nutrition, diet and physical activity before getting pregnant and then during pregnancy," Platner said in a telephone interview. "It's one of the most important things you can do to influence your pregnancy results."
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For the new study, the researchers analyzed 515,148 singleton births using data from New York City 2008-2012 that included information on pre-pregnancy weight and gestational weight gain, as well as serious delivery-related complications such as potentially diagnosing deadly, life-saving procedures or death.
About a quarter of women earned less than recommended, a third earned within the recommended range, another third gained 1 to 19 pounds more than the recommended and 8% gained more of 20 pounds over the guideline for her pre-pregnancy pregnancy rate.
Overall, the two groups with weight gains above the reference range had higher delivery complication rates. For example, these women were almost four times more likely to suffer from heart failure during a procedure, and about two and a half times more likely to require ventilation.
"We have seen the increase affect women across the spectrum for all pre-pregnancy weights," Platner said. "Many doctors and women focus on weight gain only in overweight or obese groups, but it is important that everyone talks about it, do not ignore it because they are thin before pregnancy."
Women whose pre-pregnancy BMI was lower than normal had the highest risks with a weight gain greater than the reference interval. But aside from the gestational weight gain, severe complication rates were higher for women with pre-pregnancy BMI in the obesity range.
THE WOMAN TAKEN TO LEARN AND HER KIDNEY STONE'S PAIN & # 39; IT WAS ACTUALLY WORKED
Women and their doctors need to know these weight gain guidelines during pregnancy, said Dr. Michelle Kominiarek, a specialist in maternal-fetal medicine from Northwestern Medicine in Chicago, who was not involved in the study. .
"A discussion of weight gain goals and methods to achieve these goals should be a priority for providers to have with their patients," he said by email.
Platner and his team are researching the best ways to talk to women about diet and exercise during pregnancy. For example, he said that a healthy increase in caloric intake is around 250 a day.
"A healthy diet benefits both mother and baby," said Dr. Sarka Lisonkova of the University of British Columbia in Vancouver, who was not involved in the study.
"Pregnancy is a great motivating factor for starting or continuing a healthy lifestyle, including a balanced diet with plenty of fruits and vegetables," Lisonkova said by e-mail. "This lifestyle should continue beyond pregnancy".