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Management of Obesity in Pregnancy

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Handbook of Nutrition and Pregnancy

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Abstract

Management of obesity in pregnancy presents significant challenges secondary to the plethora of maternal and fetal complications associated with pre-gravid BMI values ≥30 kg/m2. This chapter focuses on the most current and evidence-based clinical recommendations related to the Institute of Medicine’s (IOM) gestational weight gain (GWG) guidelines from 2009 and the IOM’s updated 2015 practice paper, controversies related to these GWG guidelines, maternal and fetal outcomes associated with adherence and non-compliance to these GWG guidelines, a review of factors influencing GWG, and general and nutritional recommendations for the management of maternal obesity.

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References

  1. United States Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Healthy People 2020. Washington, DC. Avaialble at https://www.healthypeople.gov/. Accessed 1 Mar 2016.

  2. Centers for Disease Control and Prevention (CDC). Preconception health and healthcare. Washington, DC. Available at http://www.cdc.gov/preconception/index.html. Accessed 1 Mar 2016.

  3. Centers for Disease Control and Prevention (CDC). Division of Nutrition, Physical Activity, Overweight and Obesity. Washington, DC. Available at http://www.cdc.gov/nccdphp/dnpao/. Accessed 1 Mar 2016.

  4. Quinlivan JA, Lam LT, Fisher J. A randomized trial of a four-step multidisciplinary approach to the antenatal care of obese pregnant women. Aust N Z J Obstet Gynaecol. 2011;51(2):141–6.

    Article  Google Scholar 

  5. Catalano PM. Obesity, insulin resistance, and pregnancy outcome. Reproduction. 2010;140(3):365–71.

    Article  CAS  Google Scholar 

  6. Sewell MF, Huston-Presley L, Amini SB, Catalano PM. Body mass index: a true indicator of body fat in obese gravidas. J Reprod Med. 2007;52(10):907–11.

    PubMed  Google Scholar 

  7. Renault KM, Nørgaard K, Nilas L, Carlsen EM, Cortes D, Pryds O, et al. The Treatment of Obese Pregnant Women (TOP) study: a randomized controlled trial of the effect of physical activity intervention assessed by pedometer with or without dietary intervention in obese pregnant women. Am J Obstet Gynecol. 2014;210(2):134.e1–9.

    Article  Google Scholar 

  8. Kapadia MZ, Park CK, Beyene J, Giglia L, Maxwell C, McDonald SD. Can we safely recommend gestational weight gain below the 2009 guidelines in obese women? A systematic review and meta-analysis. Obes Rev. 2015;16(3):189–206.

    Article  CAS  Google Scholar 

  9. Declercq E, MacDorman M, Osterman M, Belanoff C, Iverson R. Prepregnancy obesity and primary cesareans among otherwise low-risk mothers in 38 U.S. states in 2012. Birth. 2015;42(4):309–18.

    Article  Google Scholar 

  10. Catalano PM, Mele L, Landon MB, Ramin SM, Reddy UM, Casey B, et al. Inadequate weight gain in overweight and obese pregnant women: what is the effect on fetal growth? Am J Obstet Gynecol. 2014;211(2):137.e1–7.

    Article  Google Scholar 

  11. Rasmussen KM, Yaktine AL, Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight gain during pregnancy: reexamining the guidelines. Washington: National Academies Press; 2009.

    Google Scholar 

  12. Catalano PM, Nizielski SE, Shao J, Preston L, Qiao L, Friedman JE. Downregulated IRS-1 and PPARgamma in obese women with gestational diabetes: relationship to free fatty acids during pregnancy. Am J Physiol Endocrinol Metab. 2002;282(3):E522–33.

    Article  CAS  Google Scholar 

  13. Kaaja R, Laivuori H, Laakso M, Tikkanen MJ, Ylikorkala O. Evidence of a state of increased insulin resistance in preeclampsia. Metabolism. 1999;48(7):892–6.

    Article  CAS  Google Scholar 

  14. Poomalar GK. Changing trends in management of gestational diabetes mellitus. World J Diabetes. 2015;6(2):284–95.

    Article  Google Scholar 

  15. Berggren EK, Groh-Wargo S, Presley L, Hauguel-de Mouzon S, Catalano PM. Maternal fat, but not lean, mass is increased among overweight/obese women with excess gestational weight gain. Am J Obstet Gynecol. 2016;214(6):745e1–5.

    Article  Google Scholar 

  16. Smith DE, Lewis CE, Caveny JL, Perkins LL, Burke GL, Bild DE. Longitudinal changes in adiposity associated with pregnancy. The CARDIA Study. Coronary artery risk development in young adults study. JAMA. 1994;271(22):1747–51.

    Article  CAS  Google Scholar 

  17. Samura T, Steer J, Michelis LD, Carroll L, Holland E, Perkins R. Factors associated with excessive gestational weight gain: review of current literature. Glob Adv Health Med. 2016;5(1):87–93.

    Article  Google Scholar 

  18. Choi J, Fukuoka Y, Lee JH. The effects of physical activity and physical activity plus diet interventions on body weight in overweight or obese women who are pregnant or in postpartum: a systematic review and meta-analysis of randomized controlled trials. Prev Med. 2013;56(6):351–64.

    Article  Google Scholar 

  19. Office of Disease Prevention and Health Promotion: physical activity for women during pregnancy and the postpartum period. Available at http://www.health.gov/paguidelines/guidelines/chapter7.aspx. Accessed 1 Mar 2016.

  20. Rungsiprakarn P, Laopaiboon M, Sangkomkamhang US, Lumbiganon P, Pratt JJ. Interventions for treating constipation in pregnancy. Cochrane Database Syst Rev. 2015;(9):CD011448. https://doi.org/10.1002/14651858.CD011448.pub2.

  21. Thornton YS, Smarkola C, Kopacz SM, Ishoof SB. Perinatal outcomes in nutritionally monitored obese pregnant women: a randomized clinical trial. J Natl Med Assoc. 2009;101(6):569–77.

    Article  Google Scholar 

  22. Phelan S, Phipps MG, Abrams B, Darroch F, Schaffner A, Wing RR. Randomized trial of a behavioral intervention to prevent excessive gestational weight gain: the Fit for Delivery Study. Am J Clin Nutr. 2011;93(4):772–9.

    Article  CAS  Google Scholar 

  23. American College of Obstetricians and Gynecologists (ACOG). Maternal nutrition and the course of pregnancy. Washington: National Research Council; 1970.

    Google Scholar 

  24. Institute of Medicine (IOM). Nutrition during pregnancy: part I, weight gain: part II, nutrient supplements. Washington: National Academies Press; 1990.

    Google Scholar 

  25. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999-2008. JAMA. 2010;303(3):235–41.

    Article  CAS  Google Scholar 

  26. Blomberg M. Maternal and neonatal outcomes among obese women with weight gain below the new Institute of Medicines recommendations. Obstet Gynecol. 2011;117:1065–70.

    Article  Google Scholar 

  27. Rasmussen KM, Abrams B, Bodnar LM, Butte NF, Catalano PM, Maria Siega-Riz A. Recommendations for weight gain during pregnancy in the context of the obesity epidemic. Obstet Gynecol. 2010;116(5):1191–5.

    Article  Google Scholar 

  28. Durst JK, Sutton AL, Cliver SP, Tita AT, Biggio JR. Impact of gestational weight gain on perinatal outcomes in obese women. Am J Perinatol. 2016;33(9):849–55. https://doi.org/10.1055/s-0036-1579650.

    Article  PubMed  Google Scholar 

  29. Cox Bauer CM, Bernhard KA, Greer DM, Merrill DC. Maternal and neonatal outcomes in obese women who lose weight during pregnancy. J Perinatol. 2016;36(4):278–83.

    Article  CAS  Google Scholar 

  30. American College of Obstetricians and Gynecologists. ACOG Committee opinion no 548: weight gain during pregnancy. Obstet Gynecol. 2013;121:210–2.

    Article  Google Scholar 

  31. Catalano PM, Koutrouvelis GO. Clinical manager guidelines for obstetricians and gynecologists. Obes Pregnancy. 2015;126(6):112–21.

    Google Scholar 

  32. Casey PH, Whiteside-Mansell L, Barrett K, Bradley RH, Gargus R. Impact of prenatal and/or postnatal growth problems in low birth weight preterm infants on school-age outcomes: an 8-year longitudinal evaluation. Pediatrics. 2006;118(3):1078–86.

    Article  Google Scholar 

  33. Feldman R, Eidelman AI. Neonatal state organization, neuromaturation, mother-infant interaction, and cognitive development in small-for-gestational-age premature infants. Pediatrics. 2006;118(3):e869–78.

    Article  Google Scholar 

  34. Nohr EA, Varth M, Baker JL, Sorensen T, Olsen J, Rasmussen KM. Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. Am J Clin Nutr. 2008;87:1750–9.

    Article  CAS  Google Scholar 

  35. Kiel DW, Dodson EA, Artal R, Boehmer TK, Leet TL. Gestational weight gain and pregnancy outcomes in obese women: how much is enough? Obstet Gynecol. 2007;110(4):752–8.

    Article  Google Scholar 

  36. Bodnar LM, Siega-Riz AM, Simhan HN, Himes KP, Abrams B. Severe obesity, gestational weight gain, and adverse birth outcomes. Am J Clin Nutr. 2010;91(6):1642–8.

    Article  CAS  Google Scholar 

  37. Gunatilake RP, Perlow JH. Obesity and pregnancy: clinical management of the obese gravida. Am J Obstet Gynecol. 2011;204(2):106–19.

    Article  Google Scholar 

  38. Mottola MF, Giroux I, Gratton R, Hammond JA, Hanley A, Harris S, et al. Nutrition and exercise prevent excess weight gain in overweight pregnant women. Med Sci Sports Exerc. 2010;42(2):265–72.

    Article  CAS  Google Scholar 

  39. Ferrari RM, Siega-Riz AM. Provider advice about pregnancy weight gain and adequacy of weight gain. Matern Child Health J. 2013;17(2):256–64.

    Article  Google Scholar 

  40. Turner RE. Nutrition in pregnancy. In: Ross AC, Caballero B, Cousins RJ, Tucker KL, Ziegler TR, editors. Modern nutrition in health and disease. 11th ed. Baltimore: Lippincott Williams & Wilkins; 2014.

    Google Scholar 

  41. Cheikh Ismail L, Bishop DC, Pang R, Ohuma EO, Kac G, Abrams B, et al. Gestational weight gain standards based on women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: a prospective longitudinal cohort study. BMJ. 2016;352:i555.

    Article  Google Scholar 

  42. Institute of Medicine, Food and Nutrition Board. Dietary reference intakes for energy, carbohydrate, fiber, fatty acids, cholesterol, protein and amino acids. Washington: National Academies Press; 2002.

    Google Scholar 

  43. Fish: what pregnant women and parents should know. US Food and Drug Administration. U.S. Department of Health and Human Services. Available at https://www.fda.gov/Food/ResourcesForYou/Consumers/ucm393070.htm.

  44. Greenberg JA, Bell SJ, Ausdal WV. Omega-3 fatty acid supplementation during pregnancy. Rev Obstet Gynecol. 2008;1:162–9.

    PubMed  PubMed Central  Google Scholar 

  45. De-Regil L, Palacios C, Lombardo LK, Peña-Rosas J. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev. 2016;(1):CD008873. https://doi.org/10.1002/14651858.CD008873.pub3.

  46. Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW. Anemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. BMJ. 2013;346:f3443.

    Article  Google Scholar 

  47. Drehmer M, Camey SA, Nunes MA, Duncan BB, Lacerda M, Pinheiro AP, et al. Fibre intake and evolution of BMI: from pre-pregnancy to postpartum. Public Health Nutr. 2013;16(8):1403–13.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Nutrition Department, School of Medicine, Case Western Reserve University, Cleveland, OH, USA

    Hope Barkoukis

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  1. Hope Barkoukis
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Correspondence to Hope Barkoukis .

Editor information

Editors and Affiliations

  1. School of Nutrition and Food Sciences, Louisiana State University, Baton Rouge, LA, USA

    Carol J. Lammi-Keefe

  2. Department of Rehabilitation, Exercise and Nutrition Sciences, University of Cincinnati, Cincinnati, OH, USA

    Sarah C. Couch

  3. Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA

    John P. Kirwan

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Barkoukis, H. (2018). Management of Obesity in Pregnancy. In: Lammi-Keefe, C., Couch, S., Kirwan, J. (eds) Handbook of Nutrition and Pregnancy. Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-90988-2_10

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  • DOI: https://doi.org/10.1007/978-3-319-90988-2_10

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-90986-8

  • Online ISBN: 978-3-319-90988-2

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