Weight gain in Pregnancy - How much?

More than half of American women between ages 25 and 55 are overweight or obese, according to recent data from the Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey. And many women pursue the "perfect bump" by restricting how much they eat. But in reality many pregnant women are gaining way too much weight, a side effect of the nation's obesity problem. An estimated 40 percent of pregnant women have "super-sized pregnancies," in which they're gaining more than the recommended amount of weight.

The recommended weight gain is based on a woman's pre-pregnancy body mass index (BMI), which compares weight to height. The Institute of Medicine recommends that:

• women of normal weight should gain between 25 to 35 pounds and
• underweight women should gain 28 to 40 pounds
• overweight women should limit their increase to 15 to 25 pounds  
• obese women should gain about 15 pounds.

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Among women who gain more than the recommended amount, several studies have found significantly higher odds of being overweight a year after delivery.

Gaining too much weight can pose serious health problems for both mothers and their babies. Hefty moms-to-be run the risk of developing gestational diabetes, preeclampsia and having complications during delivery. Babies born to overweight mothers are more likely to be premature or have birth defects. A 2003 study published in the journal Pediatrics found that the babies of obese and overweight women faced greater risks of heart abnormalities or other birth defects like cleft palate.

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Although national birth weights for single babies have changed little in the last few decades, according to the American College of Obstetricians and Gynecologists, some doctors say that excessive weight gain during pregnancy is leading to larger babies and an increased number of Caesarean sections. In 2002, C-sections accounted for a record high 26 percent of all births, according to ACOG.

Watch the ice cream
Some women who have dieted all their lives may be relieved when they get pregnant, thinking it's finally OK to stop counting calories. But the reality, experts say, is that women need only an additional 100 calories a day during the first trimester and an average of 300 extra calories during the second and third trimesters.

Even though doctors are concerned that women stay within the weight guidelines and not pack it on nor restrict too much, the issue of how to monitor a woman's weight during pregnancy is controversial.

In England, women are weighed only at the beginning and end of the pregnancy, with medical experts citing the lack of evidence that monitoring weight promotes healthier births.

Search the Literature:

• Pregnancy and diet
• Pregnancy outcome and weight gain
• Weight gain and nutrition in pregnancy
• Patterns of maternal weight gain in pregnancy