Canadian women of reproductive age are significantly heavier than in the past and one third of women now enter pregnancy overweight (BMI > 25) or obese (BMI > 30) and this is associated with poorer pregnancy outcomes. Overall, many Canadian women are gaining weight outside their recommended ranges as defined by their pre-pregnancy BMI during pregnancy.
The Institute of Medicine (IOM) released the report Weight Gain During Pregnancy: Re-examining the Guidelines in 2009 to address excessive weight gain during pregnancy. This report found excess gestational weight gain is associated with adverse maternal and child health outcomes such as increased caesarean section rates, pre-term births, large-for gestational-age infants (>90th percentile for gestational age), macrosomic infants (4.0 – 4.5 kilograms) and postpartum weight retention.
Postpartum weight retention, one of the most important findings of the IOM (2009) report, increases the likelihood of entering a future pregnancy at a higher BMI. These women are then at additional risk of pregnancy and birth complications and at increased risk of chronic diseases related to being overweight and obese.
Health Canada has adopted the report in 2009 and revised their guidelines for gestational weight gain for Canadian women. A background document for health professionals Eating Well and Being Active: Towards a Healthy Weight Gain During Pregnancy was released this past October 2010. To help with the implementation of the new recommendations, Health Canada has developed and consulted on web-based and print information to educate women on healthy weight gains and how healthy weight gains can be achieved. These resources are expected to be available starting in early in 2011 and will be available to patients of S.O.F.T. soon after their release.
Many factors affect healthy lifestyle practices and our role as health professionals is to provide women with individualized advice as well as tools and resources to support gaining the appropriate amount of weight during pregnancy. Heathy weight gain during pregnancy optimizes positive birth outcomes, prevents postpartum weight retention and improves long-term health.
Jessica Ferris
Registered Dietitian.
To view and download the background document, visit Health Canada’s Prenatal Nutrition pages.
- Healthy Weight Gain During Pregnancy Handout
- Pregnancy Weight Gain Calculator
Adapted from Health Canada’s Guidelines Eating Well and Being Active: Towards a Healthy Weight Gain During Pregnancy. Information also from Hélène Lowell’s article Health Canada’s revised prenatal nutrition guidelines: process overview and implementation issues published in the Dietitians of Canada Paediatric Nutrition Network Newsletter Volume 9 Number 2 released October 2010 and the Institute of Medicine’s Report Weight Gain During Pregnancy: Reexamining the Guidelines published in 2009.
Visit the My Pregnancy Tool page for more resources on your pregnancy.
Read Other Articles by Jessica Ferris in the My Nutrition Tool
{ 4 comments… read them below or add one }
Hi there,
As a SOFT patient, I love all of these info pages and links and find them very useful.
Having said that, this one concerns me a little, I find all of these numbers and statistics very confusing. According to the charts I should gain between 11 and 20 lbs during this pregnancy. I am now 34 weeks pregnant and have gained about 2-4 lbs (depending on the day I step on the scale – the weight gain goes up and down). My OB does not seem to be concerned at all – but I wonder if this is okay. No matter what I do, I can’t put the weight on; I eat healthy and have a full time job running after my three year old. Should I be concerned?? I have an ultrasound this week (which I had to beg for) just to put me at ease that baby is well and growing properly. What do you think?
Sara
Hi Sara,
Those recommendations are just that; a recommended weight gain for specific body types and weights.
Dr. Frank has often said that larger women, those with a BMI over 25, often may not increase their weight at all during pregnancy and this is not harmful to the baby. The old suggestion of “eating for two” has literally been thrown out the window.
Your baby should grow normally whether you gain 10-15 pounds or not if your BMI is over 30. The guidelines are intended to be targets and maximum ranges on the high end and if you have concerns seeing a dietitian or your OB with those speific concerns would always be encouraged.
Hi Sara,
The above recommendations are just that recommendations. With the increase in overweight and obesity among the general population many women are starting pregnancy overweight or obese and then gaining in excess of these recommendations, which as mentioned above is associated with many complications and health risks for both mom and baby. Generally, in the first trimester it is assumed that women will maintain their weight or gain up to 4.4lbs. Weight gain will then begin more consistently in the second and third trimester. Many women gain the weight at different rates; some will gain it consistently and some will gain it in spurts. Overall we look at the trend of weight gain.
To specifically answer your question, in your situation what is most important is the growth of your baby. I have seen women with a BMI > 30 who have gained 2-4lbs over their total pregnancy and given birth to very healthy babies! Generally speaking we don’t want to see weight loss during pregnancy. Since you still have a month to go and your baby will be building its stores to prepare for delivery and survival outside the womb you may still gain some weight. There are specific situations where you may not gain within the recommendations, since these are guidelines for the general population as long as you are being followed closely by your OB, then there may be no concerns.
Overall, it is important to discuss your concerns with your OB. If your baby is growing well and your OB is not concerned then I would say that is a good sign.
It is admirable that through a healthy lifestyle you have not gained excessively, I really commend you on your efforts! I hope this has answered your question!
Jessica Ferris
Thanks very much, those answers are very helpful. I am really trying to stay active and eat healthy and I guess that it is a blessing that I am not putting on a tonne of weight. Hopefully after baby is born, I will be lighter and have a good start to getting back to a healthy weight.
Thanks Again,
Sara
{ 1 trackback }