Pregnancy weight gain due for review

Experts say the old targets need to be revised to take into account the obesity epidemic and the long-term health of women and children.

By Victoria Stagg Elliott, AMNews staff. Sept. 10, 2007.

"Eating for two" may soon not be much of an excuse.

New guidance on how much weight to gain while pregnant has not been issued by the Institute of Medicine since 1990, but the agency is expected to initiate the revision process within the next few months. "This is a topic of great interest," said Christine Stencel, IOM spokeswoman.

The agency hosted a workshop in May 2006 regarding the impact of pregnancy weight on maternal and child health. The objective was to consider this issue without making new recommendations, but experts now say revised guidance that encourages healthier eating and physical activity during this time is desperately needed.

Evidence has begun to indicate that women may be gaining too much, even if they stay within the accepted boundaries. The emphasis on prenatal health is also shifting to encompass a woman's and child's welfare not just during and immediately after pregnancy and birth but also far in the future.

"It's long overdue," said Raul Artal, MD, professor and chair of the department of obstetrics, gynecology and women's health at Saint Louis University in Missouri. "I would like the panel to put together new guidelines that recognize that pregnancy is not a state of confinement and women should not eat for two."

Current recommendations, more than a decade old, call for underweight women to gain between 28 lbs. and 40 lbs. Those with a normal body mass index should gain 25 lbs. to 35 lbs. Overweight women are encouraged to add 15 lbs. to 25 lbs. and those who are obese at least 15. These ranges represented an increase from previous guidelines and were issued in response to concerns about low-birthweight, pre-term birth and an increased risk of neurologic defects.