Concerns over Excessive Gestational Weight Gain

Weight gain in pregnancy is a frequent concern for expectant mothers. Though the exact amount they should gain depends on their pre-pregnancy weight, most American women gain more weight than the Institute of Medicine (IOM) recommends.

Excessive gestational weight gain (GWG) has been linked to health risks that include pregnancy-related complications, postpartum weight retention, and long-term obesity, in addition to obesity in the child. Despite those risks, few studies have examined the factors that help pregnant women achieve and maintain their recommended weights and those that predispose them to excessive GWG.

Researchers from the Penn State College of Medicine conducted a study to determine which factors might influence GWG. For their study, which was recently published in Obesity Research & Clinical Practice, the investigators conducted qualitative interviews in a convenience sample of post-partum women who were overweight or obese prior to pregnancy. They identified behaviors and attitudes about dietary habits, physical activity, and self-monitoring during pregnancy.

Eleven women had appropriate GWG, most of whom reported small increases in caloric intake, although some indicated they did not increase their intake. They also described deliberate meal and snack planning and tended to increase or maintain pre-pregnancy physical activity levels. Approximately half of the women in the group monitored their weight using GWG goals consistent with recommended guidelines as benchmarks.

Among the 18 women with excessive GWG, most ascribed to the ‘‘eating for 2” school of thought, and almost all reported exercising less during pregnancy or remaining sedentary. Approximately half of the women with excessive GWG monitored their weight, though they tended to use GWG benchmarks that were too high.

The researchers recommended that clinicians counsel pregnant women more thoroughly about appropriate GWG, stress advantageous dietary habits, and promote physical activity planning. They said physicians should also address ‘‘eating for 2’’ directly, advising women to monitor their weight gain according to the IOM guidelines.