Obesity risk for pregnancy

Obesity and pregnancy

It's well known that obesity is becoming a problem around the world, yet there is now a new fear for those who are obese who become pregnant. They are being warned not to gain anymore weight that they currently weigh.

One-fifth of pregnant women in the US are obese, and more and more doctors are advising them to watch their weight if they want an easy pregnancy and a smooth delivery.

In fact, May saw the Institute of Medicine issued guidelines lowering the minimum recommended weight gain for obese women to 11 pounds, from 15 pounds.

The report stated that American women are now a more diverse group; they are having more twin and triplet pregnancies, and they tend to be older when they become pregnant. Women today are also heavier; a greater percentage of them are entering pregnancy overweight or obese, and many are gaining too much weight during pregnancy. Many of these changes carry the added burden of chronic disease, which can put the mother and her baby's health at risk.

Healthy Moms study

To try and combat the growing epidemic, Kaiser Permanente has launched the first clinical trial to help obese women control their weight during pregnancy. The "Healthy Moms" study, funded by a $2.2 million grant from the National Institute of Child Health and Human Development. The study began recruiting in October.

The study is the first to test a weight maintenance program for obese pregnant women, and the first to use weekly support groups as part of the intervention. A small study in Denmark did limit excess weight gain in obese pregnant women, but they still gained an average of 14.5 pounds. Two other larger studies failed to prevent excessive weight gain in obese and overweight pregnant women.

The Healthy Moms trial will enroll 180 obese pregnant women from Washington and Oregon who are members of the Kaiser Permanente health plan: half will receive one-time dietary and exercise advice; the other half will attend two individual counseling sessions and then weekly group counseling for the remainder of their pregnancy. Women who attend the sessions will be weighed and encouraged to keep and turn in daily food and exercise diaries. Professional weight counselors will facilitate the groups and help motivate the women with behavior change techniques.

The study will follow women throughout their pregnancies to find out how much weight they gain, how large their babies are, and how much weight they retain one year after they give birth. It will also look at birthing complications, the baby's growth and feeding practices, and whether the mother continues with dietary changes after the baby is born. The study will recruit women for 18 months, and preliminary results are expected in three years.

"Pregnancy is what we call a teachable moment, a time when women are willing to make positive behavioral changes, because it's important for their own health and their babies' health," said Kathleen Rasmussen, a professor of nutrition at Cornell who led the institute's committee on weight gain during pregnancy, said to The New York Times.

While many women quit smoking or drinking during pregnancy, Dr. Rasmussen said, "three-quarters of pregnant women who are overweight and obese are gaining outside the recommended guidelines."

Women enrolled in the Healthy Moms trial will meet privately twice with a dietitian and participate in weekly support groups led by weight management specialists. They will be encouraged to follow a plan for eating low-fat food that emphasizes fruits, vegetables, whole grains, lean meat and low-fat dairy products and to consume only about 2000 calories per day.

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