Advertisement

Maternal Weight Gain During Pregnancy and Obesity in the Offspring

Chapter
Part of the Endocrine Updates book series (ENDO, volume 30)

Abstract

The amount of weight women gain during pregnancy may be a modifiable risk factor for childhood obesity in the next generation. Women who gain excessive weight during pregnancy have children that are more likely to be overweight from infancy through adolescence. The Institute of Medicine has issued guidelines for weight gain during pregnancy that recommend lower weight gain for women of higher pre-pregnancy BMI; however, nearly half of obese women and over 60% of overweight women in the United States are gaining above the recommended range. The optimal amount of weight gain for obese pregnant women remains controversial. When considering the optimal weight gain for obese women, the risks of low birthweight infants are balanced against risks of fetal overgrowth, maternal metabolic disorders, childbirth complications, and long-term maternal weight gain, as well as childhood obesity in the offspring. Interventions that modify diet and physical activity during pregnancy have been shown to have a modest effect on pregnancy weight gain.

Keywords

Pregnancy Weight gain Obesity Prenatal care Nutrition Exercise 

References

  1. 1.
    Rasmussen K, Yaktine A. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: The National Academies Press; 2009.Google Scholar
  2. 2.
    Abrams B, Selvin S. Maternal weight gain pattern and birth weight. Obstet Gynecol. 1995;86(2):163–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Carmichael S, Abrams B, Selvin S. The pattern of maternal weight gain in women with good pregnancy outcomes. Am J Public Health. 1997;87:1984–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Hytten F, Chamberlain G. Clinical physiology in obstetrics. Oxford: Blackwell Scientific Publications; 1980.Google Scholar
  5. 5.
    Lederman SA, Paxton A, Heymsfield SB, Wang J, Thornton J, Pierson RN. Body fat and water changes during pregnancy in women with different body weight and weight gain. Obstet Gynecol. 1997;90:483–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Rosso P. Nutrition and metabolism in pregnancy. Mother and fetus. New York, NY: Oxford University Press; 1990.Google Scholar
  7. 7.
    Naismith DJ. Adaptations in the metabolism of protein during pregnancy and their nutritional implications. Nutr Rept Int. 1973;7:383–399.Google Scholar
  8. 8.
    Institute of Medicine (U.S.). Subcommittee on nutritional status and weight gain during pregnancy, Institute of Medicine (U.S.). Subcommittee on dietary intake and nutrient supplements during pregnancy. Nutrition during pregnancy: part I, weight gain: part II, nutrient supplements. Washington, DC: National Academy Press; 1990.Google Scholar
  9. 9.
    Institute of Medicine (U.S.). Subcommittee on nutritional status and weight gain during pregnancy, Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academy Press; 2009.Google Scholar
  10. 10.
    Koupil I, Toivanen P. Social and early-life determinants of overweight and obesity in 18-year-old Swedish men. Int J Obes (Lond). Jan 2008;32(1):73–81.CrossRefGoogle Scholar
  11. 11.
    Whitaker RC. Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy. Pediatrics. Jul 2004;114(1):e29–36.PubMedCrossRefGoogle Scholar
  12. 12.
    Kim SY, Dietz PM, England L, Morrow B, Callaghan WM. Trends in pre-pregnancy obesity in nine states, 1993–2003. Obesity (Silver Spring). Apr 2007;15(4):986–93.CrossRefGoogle Scholar
  13. 13.
    Artal R, Lockwood CJ, Brown HL. Weight gain recommendations in pregnancy and the obesity epidemic. Obstet Gynecol. Jan 2010;115(1):152–5.PubMedCrossRefGoogle Scholar
  14. 14.
    Polley BA, Wing RR, Sims CJ. Randomized controlled trial to prevent excessive weight gain in pregnant women. Int J Obes Relat Metab Disord. Nov 14 2002;26(11):1494–502.PubMedCrossRefGoogle Scholar
  15. 15.
    Gray-Donald K, Robinson E, Collier A, David K, Renaud L, Rodrigues S. Intervening to reduce weight gain in pregnancy and gestational diabetes mellitus in Cree communities: an evaluation. CMAJ. Nov 2000;163(10):1247–51.PubMedGoogle Scholar
  16. 16.
    Gray-Donald K, Robinson E, Collier A, David K, Renaud L, Rodrigues S. Intervening to reduce weight gain in pregnancy and gestational diabetes mellitus in Cree communities: an evaluation. Can Med Assoc J. 2000;163(10):1247–51.Google Scholar
  17. 17.
    Olson CM, Strawderman MS, Reed RG. Efficacy of an intervention to prevent excessive gestational weight gain. Am J Obstet Gynecol. 2004;191(2):530–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Asbee SM, Jenkins TR, Butler JR, White J, Elliot M, Rutledge A. Preventing excessive weight gain during pregnancy through dietary and lifestyle counseling: a randomized controlled trial. Obstet Gynecol. Feb 2009;113(2 Pt 1):305–12.PubMedGoogle Scholar
  19. 19.
    Wolff S, Legarth J, Vangsgaard K, Toubro S, Astrup A. A randomized trial of the effects of dietary counseling on gestational weight gain and glucose metabolism in obese pregnant women. Int J Obes (Lond). Mar 2008;32(3):495–501.CrossRefGoogle Scholar
  20. 20.
    Claesson IM, Sydsjo G, Brynhildsen J, Cedergren M, Jeppsson A, Nystrom F, et al. Weight gain restriction for obese pregnant women: a case-control intervention study. BJOG. Jan 2008;115(1):44–50.PubMedCrossRefGoogle Scholar
  21. 21.
    Cogswell ME, Scanlon KS, Fein SB, Schieve LA. Medically advised, mother’s personal target, and actual weight gain during pregnancy. Obstet Gynecol. Oct 1999;94(4):616–22.PubMedCrossRefGoogle Scholar
  22. 22.
    Stotland NE, Haas JS, Brawarsky P, Jackson RA, Fuentes-Afflick E, Escobar GJ. Body mass index, provider advice, and target gestational weight gain. Obstet Gynecol. Mar 2005;105(3):633–8.PubMedCrossRefGoogle Scholar
  23. 23.
    Power ML, Cogswell ME, Schulkin J. Obesity prevention and treatment practices of U.S. obstetrician-gynecologists. Obstet Gynecol. Oct 2006;108(4):961–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Stotland NE, Gilbert P, Bogetz A, Harper CC, Abrams B, Gerbert B. Preventing excessive weight gain in pregnancy: how do prenatal care providers approach counseling? J Women’s Health (Larchmt). Apr 2010;19(4):807–14.CrossRefGoogle Scholar
  25. 25.
    Clapp JF, 3rd. Effect of dietary carbohydrate on the glucose and insulin response to mixed caloric intake and exercise in both nonpregnant and pregnant women. Diabetes Care. 1998;21:B107–12.PubMedGoogle Scholar
  26. 26.
    Clapp JF, 3rd. Maternal carbohydrate intake and pregnancy outcome. Proc Nutr Soc. 2002;61:45–50.PubMedCrossRefGoogle Scholar
  27. 27.
    Moses RG, Barker M, Winter M, Petocz P, Brand-Miller JC. Can a low-glycemic index diet reduce the need for insulin in gestational diabetes mellitus? A randomized trial. Diabetes Care. Jun 2009;32(6):996–1000.PubMedCrossRefGoogle Scholar
  28. 28.
    Moses RG, Luebcke M, Davis WS, Coleman KJ, Tapsell LC, Petocz P, et al. Effect of a low-glycemic-index diet during pregnancy on obstetric outcomes. Am J Clin Nutr. Oct 2006;84(4):807–12.PubMedGoogle Scholar
  29. 29.
    Bronstein MN, Mak RP, King JC. The thermic effect of food in normal weight and overweight pregnant women. Br J Nutr. 1995;75(1):261–75.CrossRefGoogle Scholar
  30. 30.
    McCurdy CE, Bishop JM, Williams SM, Grayson BE, Smith MS, Friedman JE, et al. Maternal high-fat diet triggers lipotoxicity in the fetal livers of nonhuman primates. J Clin Invest. Feb 2009;119(2):323–35.PubMedGoogle Scholar
  31. 31.
    Metges CC. Early nutrition and later obesity: animal models provide insights into mechanisms. Adv Exp Med Biol. 2009;646:105–12.PubMedCrossRefGoogle Scholar
  32. 32.
    Bo S, Menato G, Lezo A, Signorile A, Bardelli C, De Michieli F, et al. Dietary fat and gestational hyperglycaemia. Diabetologia. 2001;44:972–8.PubMedCrossRefGoogle Scholar
  33. 33.
    Wang Y, Storlien LH, Jenkins AB, Tapsell LC, Jin Y, Pan JF, et al. Dietary variables and glucose tolerance in pregnancy. Diabetes Care. 2000;23(4):460–4.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyUniversity of CaliforniaSan FranciscoUSA
  2. 2.Children’s Hospital Oakland Research InstituteOaklandUSA

Personalised recommendations