You are correct...

Question
What advice should be given about weight gain during pregnancy to women with a BMI > 30?

An Increase of:

1. 15-25lbs
2. 26-35lb
3. 36-40lb
4. 10-15lb

Data regarding appropriate weight gain in obese patients are insufficient to show exactly how much weight an obese patient should gain, or not gain, during her pregnancy.

Current recommendations from the US Institute of Medicine for weight gain during pregnancy suggest a gain of 20% over a woman's ideal body weight prior to pregnancy for normal-weight women. This translates into approximately 28-40 lb for underweight women, 25-35 lb for normal-weight women, and 15-25 lb for overweight women. These recommendations are based on old data, however. A recent study by Bracero and colleagues[1] showed that for average-size women, a weight gain of 31-40 lb was associated with optimal outcome, and for underweight women a weight gain of 36-40 lb was similarly associated with optimal outcome.

Data on recommendations for obese patients regarding weight gain are limited mainly because of poor sample size, confounding variables, and a lack of a uniform definition of obesity. Bianco and colleagues[2] compared morbidly obese women, defined as a BMI > 35 (> 95th percentile), with nonobese women and found that gestational weight gain was not associated with adverse perinatal outcome but it did influence neonatal outcome. They observed an increased incidence of large-for-gestational-age infants when maternal weight gain during pregnancy was more than 25 lb. Among women who had weight loss or poor weight gain, pregnancy outcome was not affected. The recommendation of the authors of this study was that a weight gain of no more than 15-25 lb was optimal. Other studies have supported these recommendations. However, no large studies have investigated the safety of weight loss during pregnancy in obese patients.

References
1. Bracero LA, Byrne DB. Optimal maternal weight gain during singleton pregnancy. Gynecol Obstet Invest. 1998;46:9-16. Abstract
2. Bianco AT, Smilen SW, Davis Y, Lopez S, Lapinski R, Lockwood CJ. Pregnancy outcome and weight gain recommendations for the morbidly obese woman. Obstet Gynecol. 1998;91:97-102. Abstract

If you have a unique Patient Question an Answer, please send to us at

publisher@diabetesincontrol.com

Question from Issue #133 

Question from Issue #134

Question from Issue #135

Question from Issue #136

Question from Issue #137

Question from Issue #138

Question from Issue #139

Question from Issue #140

Question from Issue #141

Question from Issue #142

Question from Issue #143

Question from Issue #144

Question from Issue #145

Question from Issue #146

Question from Issue #147

Question from Issue #148

Question from Issue #149

Question from Issue #150

Question from Issue #151

Question from Issue #152