Oct. 28, 2015
WEST HAVEN, CONN. -- Although many obese women vow to lose weight before they get pregnant, most of them don’t, according to research by a University of New Haven professor. So, how should they deal with pregnancy weight gain and potential complications?
New research by Anne M. Davis, an assistant professor and director of the undergraduate program in nutrition and dietetics at UNH, says obese mothers (BMI > 30 or > 120 percent of ideal body weight) may need to restrict calorie intake and even lose weight - slowly - during pregnancy.
Failing to do that, she says, may cause complications for both mother and infant. But losing weight during pregnancy is tricky because restricting calories too much may also harm the fetus.
“The rule of thumb is that the more underweight the woman, the more calories she can consume during pregnancy,” says Davis. Dieting by fasting is not a solution and harmful as demonstrated by studies of women during the Dutch famine and women who fast during Ramadan, Davis says
“Weight loss prior to pregnancy is ideal,” she says. “But 50 percent of all pregnancies are unplanned. So most of the time, the obese mother has not lost any weight before she finds herself pregnant.”
Not losing weight can lead to complications for the mother, including high blood sugar leading to gestational diabetes, high blood pressure and preeclampsia, and problems for the baby, such as being stillborn, premature, being very large and having a great risk for developing type 2 diabetes. Obese mothers who develop gestational diabetes have a higher risk than other mothers to develop Type 2 diabetes later on.
So what to do? Drastic weight loss is not an option, says Davis, because it may lead to the production of ketones in the woman’s body. Ketones are the by-products of broken down fatty acids and are harmful to mother and baby. She says pregnancy diets should never be below 1,700 calories per day.
“More investigation about defining a minimum adequate diet for obese pregnant women is critical for a safe and healthy obese pregnancy, potential maternal weight loss and fetal health,” she says.
Davis’ research shows that women who are obese are not losing weight before pregnancy, while limited and no gestational weight gain during pregnancy have failed to prevent the associated complications. “Therefore, it seems to be time to reevaluate safe caloric restriction during obese pregnancy for the prevention of pregnancy complications due to obesity,” she says.
“The obesity pandemic will affect future generations without successful prevention, intervention and management,” Davis says. “Attention to reducing obesity before, during and after pregnancy is essential for mothers and their babies.”
The University of New Haven is a private, top-tier comprehensive institution recognized as a national leader in experiential education. Founded in 1920 the university enrolls approximately 1,800 graduate students and more than 4,600 undergraduates.