Weight gain during pregnancy: norms and factors | Pampers

Risks of pregnancy and childbirth with obesity

11.06.2020

The overall weight gain during pregnancy shows too much variation between women in their daily lives or their pregnancies. About 30% of women of childbearing age are obese . Obesity is divided into four stages (according to BMI - body mass index):

• first degree - from 10 to 30% of a woman’s normal weight;
• second degree - from 30 to 50% of a woman’s normal weight;
• third degree - from 50 to 100% of a woman’s normal weight;
• class four - more than 100% above a woman's normal weight.

During pregnancy , a pregnant woman's weight increases by an average of 12-13 kilograms, and at the same time the body shape changes. The average weekly weight gain is about 300 grams. Healthy women increase their weight by an average of 17-20%. Weight gain occurs from the growing fetus, its appendages, increased fluid retention, increased blood breast enlargement and the accumulation of fat and protein reserves. During pregnancy , appetite and food intake increase. Some taste preferences also change.

Pregnancy is a condition that usually leads to a change in carbohydrate tolerance under the influence of hormones (estrogens, progesterone, placental lactogen, etc.).

What are the risks for pregnancy for an obese woman?

• Gestational diabetes is 4-6 times more common in obese
• Hypertensive diseases are more common in these women, including preeclampsia (which can be life-threatening!). Hypertension is combined with hyperlipidemia and hyperuricemia, which can lead to damage to the woman’s body
• Digestive complications - more common cholelithiasis ( gallstones )
• Childbirth proceeds tracheally (for a long time) and with a large number of ruptures of the soft birth canal. Bleeding at birth with complex etiology is more common

What are the obesity issues in pregnancy tracking?

Diagnosis associated with the initial diagnosis of pregnancy . This is due to the difficulty of obstetric examination. History is unreliable in most cases, as these women often experience menstrual irregularities, infertility , or amenorrhea.

Diagnostic difficulties are also found in some acute pregnancy , such as placental abruption (placental abruption), complications in the fibroid node, rupture (rupture) of the uterus .

Symptoms are unclear with concomitant acute surgical conditions ( appendicitis , etc.).

Difficult obstetric examination during pregnancy due to the thick anterior abdominal wall. Palpation according to Leopold (one of the methods of examining pregnant women for the presence of pregnancy ) and auscultation (listening) to heart are difficult.

Uterine height , abdominal and uterine are measured incorrectly.

Ultrasound (one of the most important methods of monitoring pregnancy !) in the fetus is not always accurate due to the thick abdominal wall. In early pregnancy, vaginal ultrasound is preferred.

The best way to give birth is difficult to predict. External pelviometry (pelvic measurement) is inaccurate due to the large amount of fat above the designated measurement points.

Internal obstetric examination of the pelvic space is also inaccurate due to the accumulation of fatty tissue, which in turn reduces the pelvic space. X-ray pelviometry is often necessary to assess pelvic size and shape (which are important indicators in determining the delivery method).

Adviсe:

• during pregnancy you should follow a diet ;
• avoid high-calorie foods;
• monitor changes in your body and do not ignore them;
• metabolic disorders such as the onset of gestational diabetes or the development of insulin resistance are being investigated for rapid supplementation.
• treatment is carried out jointly with an endocrinologist;
• delivery should be vaginal (if possible). Caesarean section is performed only for strict indications;
• Obese pregnant women complications through cesarean section than women of normal weight. The more common are infections of the surgical wound, the greater the blood loss, as well as damage to neighboring pelvic organs;
• In the postpartum period, there is a risk of endometritis (inflammation of the lining of the uterus ) and thromboembolic complications;
• After cesarean section, women are recommended early onset and prevention of thromboembolic complications using low molecular weight heparins;
• Antibiotic prophylaxis is mandatory.

Published in Endocrinology Premium Clinic

Weight gain during pregnancy

What is normal
weight gain during pregnancy?
Normal weight gain during pregnancy ranges between 7-16 kg. The number of pounds you gain during your pregnancy is determined by several factors. One of them: Your body weight immediately before pregnancy. It has been observed that women with low weight before pregnancy gain more weight during pregnancy, and vice versa, those with excess body weight gain less weight. If your weight before pregnancy is within normal values, then most likely your gain will be in the middle between 7 and 16 kg, i.e. 11 ½ kg.

Where are the added kilograms distributed?

• fruit - 3400 g
• placenta - 650 g
• amniotic fluid - 800 ml
• uterus (increases in size during pregnancy) - 970 g
• mammary glands (increase in size during pregnancy) - 405 g
• increase in blood volume by 1450 ml
• increase in extracellular fluid volume by 1480 g
• fat deposits - 2345 g

Body mass index.

To determine whether a particular patient’s weight is overweight, low or normal for his height, a special index is used in medicine - body mass index (BMI).

Body mass index = body weight in kg / height in meters 2.

Your BMI before pregnancy

• If your pre-pregnancy BMI was less than 20, this means you were underweight before pregnancy. You are likely to gain more weight in 9 months than the average woman. The recommended increase for pregnancy with a BMI less than 20 is 13-16 kg.
• If your BMI before pregnancy is between 20-27, then this corresponds to normal weight values. In this case, the recommended increase during pregnancy is 10-14 kg.
• A pre-pregnancy BMI of more than 27 indicates overweight (from 27-29 - overweight, more than 29 - obesity). This does not mean that you should try to lose weight during pregnancy. Pregnancy is not the time for dieting. Attempts to lose weight during pregnancy can negatively affect the baby's intrauterine development. Therefore, even if you are initially overweight, you need to gain a certain amount of kilograms during pregnancy, usually from 7 to 9 kg.

How does weight gain occur during pregnancy?

The rate of weight gain during pregnancy is no less important a parameter than the total number of kilograms gained over 9 months. On average, in the first 13 weeks of pregnancy you can gain from 1 to 3 kg. The recommended weight gain by 20 weeks of pregnancy is 4 kg. Further increase in body weight normally occurs gradually, approximately ½ kg per week (after the 20th week of pregnancy).

Multiple pregnancies (twins, triplets, etc.) and weight gain.

There are no clear guidelines yet on how much weight women who are carrying more than one baby should gain. Obviously, on average, they should add more than women with one child.

It is important to understand that the numbers given here are not absolute and do not represent a strict rule that you should use when assessing weight gain during your pregnancy. Regular visits to your doctor will help you monitor your weight, understand how quickly or slowly you are gaining weight, and whether the amount of weight you have gained during a particular period of pregnancy is normal for you.

Should a pregnant woman eat for two?

During pregnancy, the number of calories you consume should be increased, but this does not mean that you should eat “for two”. In the first three months of pregnancy, you need an extra 100 calories per day. During the next six months of pregnancy, energy requirements increase to 300 calories per day in addition to the normal diet.

Will it be easier for me to get back to my original weight if I try to gain less weight during pregnancy?

No. Recent studies have shown that after childbirth, both women who gained the recommended weight gain and those who gained less than they needed, there is no difference in the amount of extra weight remaining compared to their initial pre-pregnancy weight. It is known that women who breastfeed their babies have an easier time losing the weight they gained during pregnancy.

Figures and facts

Some women find it difficult to convince them that their problems getting pregnant are related to excess weight. They claim: “I’m not obese, I’m just big...” But there is an objective indicator - body mass index (calculated using the formula: weight in kilograms divided by the square of height in meters). An index of 25–30 does not indicate obesity, only some overweight. But the trouble is that reproductive dysfunction begins already with a BMI of 25–26, and as the numbers increase, the risk of infertility increases.

According to the Department of Obstetrics and Gynecology of the Russian Medical Academy of Postgraduate Education, of all women who consult doctors about infertility, 40% are overweight. Probably, such figures are also relevant for other countries, because obesity is considered an epidemic of the 21st century. The number of fat people is also growing in developed countries - and at the same time, the percentage of couples who are unable to conceive a child is growing. Russia has now come close to a critical point in terms of infertility figures: a little more, and this will become not only a medical, but also a serious demographic problem.

Yes, there are women, even very plump ones, who nevertheless become pregnant. But not thanks to excess weight, but in spite of it.

Article on the topic

Obesity kills from the inside: what diseases does excess weight cause?

For problems with conception, it is not so important whether a woman gained excess weight in childhood or only recently.

The only important thing is how quickly she can lose weight when she decides to prepare for motherhood. After all, the more “experience” you have of excess weight, the more difficult it is to get rid of it and the stronger the temptation to do this with the help of starvation diets and other abuses of the body. And in this case, it is especially important to lose weight not at any cost, but physiologically, with the help of proper nutrition and reasonable physical activity. These skills will be very useful after conceiving a long-awaited baby - those who are prone to excess weight have a much higher risk of gaining a lot of weight during pregnancy. After all, while a woman is expecting a child, she develops decreased sensitivity to insulin, which creates serious preconditions for gaining excess weight. So those who have lost weight and become pregnant need to behave especially wisely!

How to deal with excess weight during pregnancy

The main task of any obese pregnant woman is to correct her weight in order to protect herself and the unborn child from possible complications and problems. Nothing fancy is needed here, just regular weight control, as well as an excess of calories entering the body, healthy exercise, and so on. Let's look at each point in a little more detail.

Healthy food - strong baby

Nutrition is very important in any condition, not to mention carrying a future little person. The mother must initially give him the right substances, minerals, vitamins, microelements so that he develops correctly and is healthy. Therefore, her nutrition should be especially correct during this period.

• Choose only healthy, minimally processed foods.
• Avoid fast food, excessively fatty, fried, salty.
• An excess of sweets will also not bring anything good.
• Take more vitamins; vegetables and fruits are what you can consume with almost no restrictions.
• Give your body more protein and fiber, while slightly reducing your intake of carbohydrates and fats.

It is recommended not to eat too much once a day, but to provide a regimen of fractional meals. To do this, you need to divide your daily diet into five to six servings, which you should eat during the day. Any emergency or strict diet for pregnant women with excess weight is contraindicated, but you shouldn’t overeat for three either. Keeping a balance in everything is the main rule that you should follow when planning to give the world a new little person.

Water, vitamins, minerals

It is very necessary to organize the correct drinking regime. Water not only burns excess fat, but also saturates all tissues with strength and energy. At the same time, it washes away toxins, and is responsible for much more. Therefore, remember that you need to drink a lot, at least one and a half liters a day, then both mother and baby will be healthy.

With excessive weight gain, many pregnant women use fasting days, when they limit themselves only to drinking. However, you must remember that such steps can only be taken on the recommendation and under the supervision of your doctor. Otherwise, you can harm yourself and your child, which is unacceptable.

Vitamin B9 – folic acid – is especially important for mother and child. You can get a good portion of it by simply eating parsley or spinach, which are rich in this substance. This will reduce the risk of developing fetal pathologies and congenital defects by eighty percent. To prevent the development of rickets, you need to think about taking vitamin D. It is best to get it naturally - from sunlight, but an additional portion will also not hurt. Therefore, eat nuts, milk, eggs, mushrooms and the same spinach.

Physical education for mother and baby

It’s good if the expectant mother led an active lifestyle before pregnancy, played some kind of sport, or simply kept herself in shape. Then it won’t be difficult to get rid of the few kilograms you’ve gained. If she had never previously attached much importance to this, then it makes sense to start now. Even ordinary walks in the park or embankment will provide many benefits for both the woman and her unborn child.

Therapeutic exercises for weight loss are also quite acceptable. However, classes must be carried out under the strict supervision of a physician or professional trainer with relevant experience.

Strict health monitoring

Every woman wants not only to give birth to a healthy baby, but also not to get a “bouquet” of various problems during pregnancy. It is unlikely that you will be able to cope on your own, so it is better to leave health care to doctors.

• Preventing deep vein thrombosis during pregnancy is a challenge for everyone who is overweight.
• Timely detection and control of diabetes in pregnant women is important. You need to closely monitor your blood sugar levels. The main signs of this phenomenon may be constant thirst, dry mouth, blurred vision, and frequent urge to urinate. Physical activity plays a significant role in this case, burning excess unspent glucose.
• It is a good idea to keep a close eye on your blood pressure, as some people develop preeclampsia. This is the inability of the mother’s body to adapt to providing the fetus with everything necessary. Another sign is the presence of protein in the urine and constant swelling, insomnia, and cramps.
• Typically, ultrasound during pregnancy is prescribed three times - at 11, 20 and 33–34 weeks. However, if you are overweight, it is permissible to conduct additional research, especially since they are completely safe for mother and baby.

An important factor is regular weight monitoring, especially if you were overweight before pregnancy.

Due to excess weight of the expectant mother, the risk of the following conditions increases:

1. In the early stages, the risk of miscarriage increases. Let me hasten to reassure you that it is increasing slightly, but it is still happening. More often in women over 35 years of age.

2. The likelihood of having a child with developmental defects increases. Children of very plump mothers more often develop defects of the neural tube, heart, abdominal wall, and cleft palate. Experts attribute the formation of these defects to a lack of vitamin B9 (folic acid). It is more difficult for a pregnant woman with excess body weight to calculate the required dose of folic acid, which is very important in the first six weeks of pregnancy, when active cell division and embryonic organ formation are taking place. Also, the cause of developmental abnormalities in the baby may be metabolic disorders (increased levels of insulin, uric acid, triglycerides, endogenous estrogens).

3. In an overweight woman, it is more difficult to diagnose some complications. Developmental defects and growth retardation may not be noticed due to poor visualization during ultrasound examination. Palpation of the abdomen in an obese pregnant woman can also be uninformative.

4. Don’t forget about the diagnoses that women face in the second half of pregnancy. Obesity has a higher risk of preeclampsia, preeclampsia, and diabetes. If a mother develops diabetes, her metabolism accelerates. Because of this, the fetus may experience oxygen starvation, which will lead to its organs being underdeveloped. At the same time, the baby’s weight can be enormous. This, of course, will complicate childbirth. For the mother, a large fetus is fraught with caesarean section or rupture during natural childbirth, and for the fetus - with birth injuries.

5. In the distant future, most likely, the mother may develop postpartum endometritis, and the child will suffer from obesity.

“According to statistics, multiparous women most often face obesity - 50-68%. But there are also very plump women among those who are expecting their first child - 16%. To understand how relevant this problem is to you, calculate your body mass index (BMI). Divide your weight in kilograms by your height in meters squared. If the result is more than 30, you are obese,” says Tatyana Butskaya.

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