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Midwives should be instructed on how to advise pregnant women about weight management, said their professional body, responding to research suggesting that the widespread belief that pregnant women need to eat for two was a myth.
According to the study published in the journal Diabetologia, taking too much weight during pregnancy could increase the risk of insulin resistance in the future offspring and affect its blood pressure in children.
Previous research that suggested that weight gain during pregnancy could have consequences, a global study conducted last year revealing that 75% of pregnant women have not gained weight in a healthy way. Weight gain above or below recommended levels during pregnancy has been associated with various problems related to baby size and delivery.
"We have to educate the mother – it's not just [a] large [baby] they would have and now we have evidence that this will affect the future of the baby, "said Professor Wing Hung Tam, co-author of the Chinese University of Hong Kong study, although He stated that pregnant women should not feel the need to start weighing you every two weeks.
Tam rejected the idea of pregnant women "eating for two." The Royal College of Obstetricians and Gynecologists notes that women do not need extra energy for the first two trimesters and need only 200 extra calories a day during the last three months of the pregnancy.
"In the UK, this study highlights the need for guidelines on weight gain during pregnancy," said Mandy Forrester, quality and standards manager at the Royal College of Midwives. She said that, in the absence of such advice, some British midwives should "use their own initiative and refer to US guidelines".
Forrester added, "Midwives clearly need the tools, guidance and training they need to be able to provide women with the best support and the best care possible. This is especially urgent because of the potentially serious complications that can occur during pregnancy due to being overweight or obese in women. It is to be feared that some midwives do not have access to this equipment, the most basic balance.
The mention of scales raised the specter of a return to the weighing of pregnant women. The NHS practice of regularly weighing women during pregnancy was gradually phased out in the early 1990s on the pretext that it caused unnecessary stress for little benefit.
In their article, Tam and his colleagues described how they followed the health of 905 pairs of mothers and their children in Hong Kong.
The mothers' weight before pregnancy was self-reported and the birth weight was taken from medical records, which allowed for calculation of body mass index and weight gain during pregnancy. Women were then classified as receiving too much, too little or the recommended weight levels – according to US guidelines – during pregnancy.
The results show that while 42% of women gained weight during pregnancy, 17% gained too little and 41% too much – women in the second group were more likely to be young, had a higher BMI and pregnancy .
Between 2009 and 2013, when children were seven years old, offspring were examined for weight, height, waist circumference, and blood pressure.
After taking into account factors such as sex, weight and age of the child, blood sugar during pregnancy, childbirth and exercise at home. As a child, the team found that women's children weighed heavier, taller and had a higher BMI and waist circumference than women with the recommended weight levels.
They also tended to have higher blood pressure and signs of greater insulin resistance – factors that the team found, at least in part, related to children's greater BMI.
The effects for children of mothers who gained less weight than recommended during pregnancy were less marked, perhaps because fewer children were studying and the deviations from the recommended weight gain were smaller. risk of insulin resistance and hypertension.
Tam said that the size of the effects was not necessarily a cause for alarm and that the study showed only associations, while the children had to be followed up to the next day. adulthood to further explore the effects. The team also noted that the guidelines on weight gain during pregnancy had been developed for American women, while the study only concerned women of Chinese descent and that taking weight during pregnancy was not measured repeatedly.
Tam said women needed more support to monitor their weight during pregnancy and advice on recommended weight gain levels early on.
Debra Bick, a midwifery and maternal health teacher at King's College London, said the focus should be on helping women before they become pregnant.
"I advise women who are planning a pregnancy to think about their weight, as this can have a significant impact on their lives and those of their child," she said.
Dr. Daghni Rajasingam, a spokesperson for the Royal College of Obstetricians and Gynecologists, said, "These findings add to the growing body of evidence that weight gain during pregnancy poses an increased risk of complications.
"These results are particularly relevant in the UK, where one in five pregnant women is obese. Women are encouraged to maintain a healthy weight before, during and after pregnancy by eating a balanced diet and participating in regular exercise. It is also important to avoid dieting during pregnancy, even if a woman is obese, as this could harm the unborn baby.
"Having a healthy weight before conception increases the chances of getting pregnant naturally and reduces the risk of pregnancy and birth complications for both mother and baby."
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