Current recommendations for weight gain during pregnancy - developed in 1990 - should be revised as soon as possible, according to an obesity expert at Saint Louis University. Raul Artal, who has conducted extensive research on obesity during pregnancy, said that current recommendations encourage obese women to gain at least 15 pounds during pregnancy and specify no upper limit for weight gain. Artal contends that overweight or obese women don't need to gain that much weight and should exercise and watch their calorie consumption during pregnancy. "Pregnancy has become over the years a state of indulgence and confinement," he wrote in the journal Expert Review of Obstetrics and Gynecology. "[But] pregnancy is an ideal time for behavior modification that includes physical activity and with proper medical supervision it can be safely prescribed."
The previous guidelines were not grounded in scientific evidence, Artal noted, and focused primarily on preventing low birth-weight deliveries, which generally occur when women who are underweight and of normal weight don't gain enough weight during pregnancy. But the guidelines did not take into account the other factors that could restrict the growth of babies. Nor did they consider the impact of excessive weight gain on the health of the fetus and mother, he wrote.
"There is still a prevailing reluctance among health care providers to prescribe lifestyle modification in pregnancy that includes judicious diet and exercise," Artal said. "The perception is that pregnancy is not an opportune time for such interventions because of potential risk to the fetus."
Artal recommends that in uncomplicated pregnancies, all women, even those who are obese, should engage in physical activity. "Previous studies have demonstrated that engaging in exercise activities in pregnancy is safe," he wrote. "Obese women should not be precluded from engaging in physical activities. Obese pregnant women who engage in physical activities during their pregnancies reduce their risk of developing gestational diabetes by 50 percent."
"We can certainly speculate that for overweight and obese pregnant women who gained at least 15 pounds during their pregnancies, pregnancy has become a major contributing factor to the epidemic of obesity, since the general tendency is to retain the weight post-partum," he said, urging overweight women who are pregnant to exercise and change their eating habits.
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Source: Saint Louis University
