Question

Tina is a moderately active 26-year-old at the end of her fourth month of pregnancy. She is 5 feet 4 inches tall and weighed 125 lb at the start of her pregnancy. She is concerned about gaining too much weight because her sister gained 50 lb during her pregnancy and has had difficulty losing the excess weight since her baby was born.  Tina’s obstetrician recommends that she gain 25-35 lb during her pregnancy, but she would like to keep her weight gain to only 15 lb.  

Q: Based on the graph below, why would gaining only 15 lb put the baby at risk?  Why would gaining 50 lb put the baby at risk?

Answer 1

In normal pregnancy, variable amount of weight gain is a constant phenomenon. In early weeks, the patient may lose weight because of nausea or vomiting. During subsequent months, the weight gain is progressive until the last 1 or 2 weeks, when the weight remains static. The total weight gain during the course of a singleton pregnancy for a healthy woman averages 11kg.This has been distributed to 1 kg in first trimester and 5kg each in second band third trimester. Rapid weight gain of more than 0.5 kg a week or more than 2 kg a month in later months of pregnancy maybe the early manifestation of preeclampsia and need for careful supervision. Stationary or falling weight may suggest intrauterine growth retardation or intrauterine death if fetus. Obese women are in increased risk of complications in pregnancy, labor and puerperium. Ideally weight gain should depend on pre-pregnancy body mass index level. Weight gain for a woman with normal BMI (20-26) is 11-16 kg. An obese woman should not gain more than 7kg, whereas an underweight woman may be allowed to gain upto 18kg.Maternal nutrition and weight gain during pregnancy are directly related to the newborn weight. Any excess weight gain maybe due to excess fluid retention and could be the first sign of pre-eclampsia. If the weight gain is less than normal, stationary or even falling, one should be on the look-out for intrauterine growth restriction.