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New Research Suggests Lowering or Removing Current Recommendations
The longstanding guidelines recommending weight gain during pregnancy for obese women may need revision, according to groundbreaking research from Karolinska Institutet, published in The Lancet. The study challenges the existing recommendation of a weight gain of at least 5 kg for pregnant women with obesity, suggesting that lower weight gain or even weight loss may be safe and beneficial.
Current international guidelines, including those from the U.S. Institute of Medicine (IOM), advise women with obesity to gain between 5 to 9 kg during pregnancy. However, these guidelines have faced scrutiny over the years, lacking substantial evidence to support a re-evaluation.
The study, conducted by researchers at Karolinska Institutet in Sweden, analyzed data from over 15,000 women with obesity, classifying them into different obesity classes based on their BMI. The findings revealed that for women with obesity class 1 and 2 (BMI of 30–34.9 and 35–39.9, respectively), weight gain below current guidelines posed no increased health risks for either the mother or the child. In fact, lower weight gain may even be beneficial for those with obesity class 3 (BMI over 40).
Kari Johansson, docent at the Department of Medicine, Solna, emphasized the significance of the study’s findings in informing a re-evaluation of pregnancy weight gain guidelines. Johansson expressed hope that the research would lead to revisions in national and international guidelines to better support pregnant women with obesity.
The study examined ten adverse outcomes associated with weight gain during pregnancy, including pre-eclampsia, gestational diabetes, and preterm birth. It found no increased risks of adverse outcomes with weight gain below current guidelines for women with obesity classes 1 and 2. Conversely, for women with obesity class 3, lower weight gain or weight loss were associated with reduced risk of adverse outcomes, such as pre-eclampsia and gestational diabetes.
Johansson noted that the results suggest a need for tailored recommendations for women with obesity class 3, advocating for separate guidelines to address their unique needs.
Moving forward, the researchers plan to conduct similar studies on women with different weight categories, including overweight, normal weight, and underweight, to further refine pregnancy weight gain recommendations.
The findings of the study underscore the importance of evidence-based guidelines to support the health and well-being of pregnant women, particularly those with obesity, and pave the way for more personalized care during pregnancy.
