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Obese Women Less Likely to Loss Weight Gained During Pregnancy


In the largest U.S. study done to examine effects of weight gain during pregnancy in obese women researchers have found that those who gain more than the recommended amount during pregnancy are much less likely to loss the weight gained during the pregnancy within one year after they give birth.

Kim Vesco, MD, MPH and colleagues published their findings in the November issue of Obstetrics & Gynecology. The retrospective cohort study of 1,656 obese women found that most of them gained too much weight during pregnancy, then, on average, kept on 40 percent of the weight one year after they gave birth. For example, if a woman gained 20 pounds during pregnancy, she could be expected to retain 8 of those pounds at one year.

The researchers looked at 1,656 singleton gestations resulting in live births among obese women between January 2000 and December 2005 in Kaiser Permanente Northwest. The study defined obesity as a body mass index (BMI) at or above 30 kg/m2.

The amount of pregnancy weight change was measured as the difference between the last available pre-delivery weight minus weight at pregnancy onset. The weight gained during pregnancy was categorized as less than 0 lbs, 0-15 lbs, greater than 15 to 25 lbs, greater than 25 to 35 lbs, and greater than 35 lbs.

Postpartum weight change was measured as the difference between the weight at 1 year postpartum minus weight at pregnancy onset. This weight-loss was defined as less than 0 lbs, 0-10 lbs, and greater than 10 lbs.

The researchers found that the total gestational weight gain ranged from -33.2 (weight loss) to +98.0 pounds (weight gain). Nearly three fourths of the women gained greater than 15 pounds.

Pregnancy-related weight change showed a significant relationship with postpartum weight change. For each pound gained during pregnancy, there was a 0.4-pound increase above baseline weight at 1 year postpartum. These obese women who gained the most weight during pregnancy were less likely to have lost the pregnancy-related weight a year later.

The study defined excess weight as more than 15 pounds, which until recently was the minimum amount of weight gain recommended for obese pregnant women by the Institute of Medicine. In May 2009, the IOM set an upper limit for weight gain in obese pregnant women, suggesting they gain between 11 – 20 pounds.

The study lead author Kim Vesco, MD states “This extra weight also increases the risk of pregnancy and delivery complications like diabetes, preeclampsia, bigger babies, C-sections, and birthing injuries.”

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The goal is to prevent the weight gain in the first place. Both the moms and babies will be healthier in the long run.

Tips for Controlling Excess Weight Gain During Pregnancy

* Every day eat 8 – 12 fruit and vegetable servings, 3 servings of low-fat dairy, 5 – 9 ounces of protein-rich foods, 6 – 10 servings of whole grains, and 3 – 7 teaspoons of healthy fat (e.g., olive or canola oil, nuts).

* Eat regular meals and small healthy snacks between meals.

* Reduce fat to less than 30 percent of calories.

* Reduce consumption of sweets and sweetened drinks.

* Keep a food diary to check for nutritional adequacy and portion management.

* Eat only 100 – 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.

Kaiser Permanente News Release
Excessive Gestational Weight Gain and Postpartum Weight Retention Among Obese Women; Obstetrics & Gynecology. 114(5):1069-1075, November 2009; Vesco, Kimberly K.; Dietz, Patricia M.; Rizzo, Joanne; Stevens, Victor J.; Perrin, Nancy A.; Bachman, Donald J.; Callaghan, William M.; Bruce, F Carol; Hornbrook, Mark C.; doi: 10.1097/AOG.0b013e3181baeacf



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