Excess pregnancy weight gain affects cardiometabolic risk in offspring

Pregnant mothers have been advised to eat for two for centuries. A professional body for midwives now has come up with recommendations that this belief is a myth and pregnant women should be advised how to better manage their body weights.

This recommendation is based on a new study that shows that excessive weight gain during pregnancy can raise the risk of insulin resistance and lead to high blood pressure among the offspring.

The study results appeared in the latest issue of the journal Diabetologia.

Image Credit: Staras / Shutterstock
Image Credit: Staras / Shutterstock

Another recent study had shown that three out of four pregnant women did not gain weight in a healthy manner.

Excessive weight gain as well as inadequate weight gain has been linked to problems of premature delivery and size and weight of the baby at birth. Prof Wing Hung Tam, the co-author of the study from the Chinese University of Hong Kong explained that all pregnant women should not start weighing themselves each week but should be made aware of the positive outcomes of healthy weight gain during pregnancy and the detrimental effects of excessive weight gain during pregnancy. Tam said that mothers need to dispel the myth of eating for two.

The Royal College of Obstetricians and Gynaecologists have in their recommendations stated that extra energy is not required for mothers during the first two trimesters. During the last trimester of pregnancy only around 200 calories of extra energy is required.

For this study the researchers looked at the health of 905 mothers and their babies in Hong Kong. The mothers were weighed before pregnancy and at delivery. The changes in body mass index was calculated and the weight gained during pregnancy was assessed. US guidelines were used to see if the women gained too much or too little weight.

Results showed that 42 percent women gained weight within recommended levels while 17 percent had inadequate weight gain and 41 percent women gained excessive weight. Women who gained too much weight during pregnancy tended to be younger, have a higher baseline body mass index and a longer pregnancy duration.

The mothers and their children were followed up for seven years between 2009 and 2013. The children were examined at seven years and their weight, height, blood pressure, waist circumference were recorded. Other factors were accounted for. These included the child’s sex, birth weight, mother’s diabetic status during pregnancy, form of delivery, childhood exercise etc.

Taking into account these factors, it was noted that children born of mothers who gained excessive weight tended to be heavier, taller and had a greater waist circumference compared to those born to mothers who gained weight normally. Alarmingly, these children also had a greater blood pressure and risk factors for insulin resistance.

Women who gained inadequate weight during pregnancy did not bear children with such significant risks but these children also tended to have risk factors for insulin resistance and higher blood pressure write the researchers.

According to Tam, these women were of Chinese ancestry and similar studies need to be conducted among women from different ethnic backgrounds.

According to Mandy Forrester, the head of quality and standards at the Royal College of Midwives this study shows the need for recommendations for pregnant women in UK regarding weight gain. She added that midwives in UK have to reply on US guidelines in this regards. “There is a clear need for midwives to have the tools, guidance and training they need so that they can offer women the best possible support and care.

This is especially pressing because of the potentially serious complications that can arise in pregnancy as a result of women being overweight or obese. It is a real concern that some midwives do not have access to that most basic piece of equipment, scales,” she said. She said that the NHS used to routinely weigh pregnant women during their antenatal check-ups.

This was phased out in the 1990’s citing reasons that this practice caused undue stress among the pregnant women and was not really beneficial.

According to the present Institute of Medicine's Weight Gain Recommendations for Pregnancy the recommendations are;

  • Inadequate weight gain – of 28-40lb (12.7-18.1kg)
  • Normal weight gain – of 25-35lb (11.3-15.9kg)
  • Overweight means a gain of 15-25lb (6.8-11.3kg)
  • Obese means a gain of 11-20lb (5-9.1kg)

Dr Daghni Rajasingam, a spokesperson for the Royal College of Obstetricians and Gynaecologists, said in a statement, “These findings add to the growing body of evidence that shows the increase in risk of health complications from too much or too little weight gain during pregnancy.

These findings have particular relevance in the UK where one in five pregnant women are obese.

Women are encouraged to maintain a healthy weight before, during and after pregnancy by eating a well-balanced diet and taking part in regular exercise. It is also important to avoid dieting during pregnancy, even if a woman is obese, as this may harm the unborn baby.

Having a healthy weight before conception increases the chances of falling pregnant naturally and reduces the risk of pregnancy and birth complications for both mother and baby.”

The National Institute of Health and Care Excellence is in the process of updating 2010 guidelines.

Dr. Ananya Mandal

Written by

Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.

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