PORTLAND, Ore. — A new study finds that women who are obese can limit their weight gain during pregnancy using conventional weight loss techniques, including attending weekly group support meetings, seeking advice about nutrition and diet, and keeping food and exercise journals.
Results of the Healthy Moms study, published in Obesity, also show that obese women who limit their weight gain during pregnancy are less likely to have large-for-gestational age babies, which can complicate delivery and increase the baby’s risk of becoming obese later in life.
“Most interventions to limit weight gain among obese women during pregnancy have failed, but our study shows that with regular contact and support, these women can limit the amount of weight they gain, which will also reduce the risk of complications during and after pregnancy,” said author Kim Vesco, MD, MPH, a practicing obstetrician/gynecologist and clinical investigator with the Kaiser Permanente Center for Health Research in Portland, Ore.
Excessive weight gain during pregnancy has been linked to complications such as preeclampsia, gestational diabetes, an increased rate of C-sections, birthing injuries and weight retention after pregnancy.
Commonly used guidelines from experts at the Institute of Medicine suggest that women who are obese gain between 11 and 20 pounds during pregnancy. Based on observational studies that suggest weight maintenance or limited weight gain may result in better pregnancy outcomes, the Healthy Moms study advises obese women to maintain their weight during pregnancy.
“Most women in our intervention did gain some weight, but they gained and retained significantly less than women who did not participate in the intervention,” said Dr. Vesco. “Even with support, it’s difficult to limit weight gain during pregnancy, so women who are overweight or obese should aim for the lower end of the weight-gain range recommended by the Institute of Medicine, and they should seek support and nutritional advice to help meet their goals.”
The Healthy Moms study included 114 obese women who are Kaiser Permanente Northwest members. Women are considered obese if they have a body mass index of 30 and above; for instance, a woman who is 5 feet 5 inches tall would be considered obese at 180 pounds.
- Tips for Controlling Excess Weight Gain During Pregnancy
- At your first pre-natal visit, set a weight gain goal with your provider. Track your progress throughout your pregnancy.
- Fill half your plate with fruits and vegetables, a quarter of your plate with a healthy protein like chicken, fish or low-fat beef, and another quarter with a starch or healthy grain.
- Eat healthy fats, like those found in olive oil, avocados or salmon.
- Eat regular meals and small, healthy snacks between meals.
- Reduce consumption of sweets and sweetened drinks; try replacing those drinks with water.
- Keep a food diary to check for nutritional adequacy and portion management.
- Beginning in the second trimester, eat only 200-300 extra calories per day beyond what your calorie needs were before you became pregnant.
- Exercise 30 minutes on most days. If you aren’t exercising, talk to your provider about how to start an exercise program.
Half of the women participated in an intensive weight-management program that included weekly group meetings, weigh-ins, personalized caloric goals, and food and exercise diaries. The other women were placed in a usual care group consisting of one meeting with a dietitian, at which they received general information about diet and exercise for a healthy pregnancy.
By 34 weeks of pregnancy, women who participated in the intensive, weekly group intervention had gained an average of 11 pounds, compared to 18 pounds for women who did not participate in the intervention. Two weeks after delivery, participants in the intervention weighed approximately 6 pounds less than they did when they were brought into the study, compared to an average weight gain of 3 pounds for women who did not participate in the intervention.
Women in both groups had about the same number of birthing and delivery complications, but only 9 percent of women in the intervention had large-for-gestational age babies, compared to 26 percent of women in the control group. These babies usually grow too fast in the womb, and at birth they weigh more than 90 percent of babies of the same sex and gestational age. For example, a baby boy born at 40 weeks would be considered large for his gestational age if he weighed more than 9 pounds, 3 ounces.
The intervention showed no adverse effects on pregnancy outcomes, but researchers say a larger study is needed to confirm this finding and to understand more about the impact of limited weight gain or weight loss on pregnancy outcomes.
This study was funded by a grant from the National Institute of Child Health and Human Development. (RO1HD058061)
In addition to Dr. Vesco, authors include Njeri Karanja, PhD, Michael C. Leo, PhD, Nancy Perrin, PhD, Sabina Smith, BS, CCRP, and Victor J. Stevens, PhD, from the Kaiser Permanente Center for Health Research in Portland, Ore.; Janet C. King, PhD, from Children’s Hospital Oakland Research Institute in Oakland, Calif.; Matthew W. Gillman, MD, from the Obesity Prevention Program, Harvard Medical School in Boston; Cindy T. McEvoy, MD, MCR, from Oregon Health & Science University in Portland; and Cara L. Eckhardt, PhD, from the School of Community Health at Portland State University in Portland.
About the Kaiser Permanente Center for Health Research
Kaiser Permanente’s Center for Health Research, founded in 1964, is a nonprofit research institution dedicated to advancing knowledge to improve health. It has research sites in Portland, Oregon, Honolulu, Hawaii, and Atlanta, Georgia.
About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve approximately 9.5 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.