Excessive Weight Gain During Pregnancy Poses Health Risks

The health risks associated with weight gain are well known, but when you are pregnant it takes on a whole new significance. While it’s true that you are “eating for two” eating twice as much usually results in excessive weight gain, meaning you will have more difficulty losing the weight after the baby is born. It also means an increased risk of having a large baby. According to a new study, gaining 40 pounds or more during pregnancy almost doubles the risk of having a baby that weighs 9 pounds or more, posing health risks to both mother and child. Bigger babies can mean riskier births, including vaginal tearing and bleeding, and often the need for a Caesarean section. For the baby there is a risk of getting stuck in the birth canal, often leading to broken collar bones. Heavier babies are also prone to obesity and type 2 diabetes later in life, the study authors said.

For the study, researchers at the Kaiser Permanente Center for Health Research in Portland, Oregon looked at 41,540 pregnant women who gave birth to singleton babies in Hawaii, Oregon and Washington from 1995 through 2003. Patient medical records and birth certificates were used to determine the mother’s weight and the baby’s birth weight. All mothers-to-be also underwent glucose screening for gestational diabetes, which is a known risk factor for having a heavier baby. More than 20 percent of those who gained more than 40 pounds gave birth to large babies, compared to less than 12 percent of those who gained less than 40 pounds. Of those who both gained more than 40 pounds and suffered gestational diabetes, 29.3 percent had big babies, while the odds for women with normal glucose levels and who gained less than 40 pounds were only 9.3 percent. “More than one in five women gain too much weight during pregnancy and only 5 percent have gestational diabetes,” said the study’s lead author Teresa Hillier, M.D., an endocrinologist and senior investigator at the Kaiser Center.

The study concludes that women should be careful about their weight during pregnancy. Current guidelines issued by the federal Institute of Medicine in 1990, which are now being re-evaluated, advise that an underweight mother (BMI below 19.8) gain 28 to 40 pounds; women with normal weight (BMI of 19.8 to 26.0) gain 25 to 35 pounds; and overweight women (BMI above 26) gain 15 to 25 pounds during pregnancy. But, surprisingly, a third of the women surveyed in an unrelated study said they received no advice about gestational weight gain from their health care providers. “Providers should do a better job about counseling,” Dr. Hillier said. “They need to pay attention to weight, and focus on healthy weight gain.”

But Hillier also cautioned, “Not gaining enough (weight during pregnancy) is a risk for the baby as well. The focus should be eating healthfully: low-fat dairy, protein, lots of fruit and vegetables, also, under the guidance of a physician, getting moderate amounts of exercise.”

The study was published in the November issue of Obstetrics and Gynecology.

Should Women Say NO to Caffeine During Pregnancy?

By: Allie Montgomery

Caffeine is a morning ritual most people don't think twice about. In this age of Starbucks and $4 lattes, coffee seems to have become a regular part of the daily diet. Getting pregnant means having to change that habit, and the amount of caffeine intake, whether it is from coffee, tea, soda or other forms.  Women who are pregnant and consume caffeine, even as little as one cup of coffee a day, are at a higher risk of delivering an underweight baby.

In January 2008, researchers from the U.S. found that pregnant women that consumed two or more cups of coffee daily are at twice the risk of having a miscarriage as those women who avoid caffeine during their pregnancy. These findings are the most recent in mounting evidence indicating that the amount of caffeine a person consumes could directly impact their health, especially women who are pregnant.

Babies that are born underweight are more likely to develop a wide range of health conditions when they grow older, including problems such as heart problems, diabetes, and high blood pressure. There are also more serious complications that can arise with caffeine such as the caffeine can cause the blood vessels to constrict, and it may reduce the blood flow to the placenta, and since it is so easily crosses the placenta and reaches your baby (who then very slowly metabolizes it), caffeine may directly affect his developing cells. It has also been show that pregnant women who drink eight or more cups of coffee a day double the risk of having a stillbirth or miscarriage.

In the U.S. study, women who were pregnant that consumed one to two cups of coffee per day, or between 100-199 milligrams, had a 20 percent increased risk of having a baby with a low birth weight. This data was compared to the women how consumed less than 100 milligrams per day.

Justin Konje and his colleagues from the University of Leicester in Britain wrote, “Caffeine consumption during pregnancy was associated with an increased risk of fetal growth restriction and this association continued throughout pregnancy. Sensible advice would be to reduce caffeine intake before conception and throughout pregnancy.”

Konje and his research team, which included some researchers from the University of Leeds, looked at approximately 2,645 women at an average age of 30 who were between 8 and 12 months into their pregnancy. The women studied reported an average caffeine intake during their pregnancy of 159 milligrams daily, which is lower than the new recommended limits of 200 milligrams in Britain.

The likelihood of having a baby with a low birth weight rose to 50 percent for women that consumed between 200 milligrams and 299 milligrams daily, which is about two to three cups of coffee. Even small amount of caffeine may prove to be harmful, but Konje said that the best advice would be to limit caffeine consumption to below 100 milligrams daily. “We couldn’t say that there was a lower limit for which there is no effect,” he stated. “My advice is if possible to reduce caffeine intake to a minimum. You have to be realistic because you can’t ask people to stop taking caffeine.”

It is never easy to just completely cut off caffeine when you are used to having it every day. If you are a devoted cola drinker or java junkie, you may experience caffeine withdrawal and it won’t be easy. To minimize the symptoms of caffeine withdrawal, which may include lethargy, irritability, and headaches, you may want to ease of gradually. You can start mixing decaf with you regular cup of caffeinated coffee. Or you can reduce the caffeine in homemade hot beverages by simply brewing them weaker or for a shorter time. If you happen to love a cup of soothing English Breakfast, steeping you tea bag for just one minute instead of five minutes reduces the caffeine by as much as half.

Although herb teas often have no caffeine in them, be sure to read the ingredients list and speak with you healthcare provider before trying anything new, as certain herbs and additives are not safe during a pregnancy.

Here is a chart of amounts of caffeine in common food and beverages to help you decide what to cut back on.

For the Coffee Lovers  
generic brewed coffee    8 oz    102-200 mg
Starbucks brewed coffee    16 oz (grande)    330 mg
Dunkin' Donuts brewed coffee    16 oz    206 mg
Starbucks caffÉ latte or cappuccino    16 oz (grande)    150 mg
Starbucks caffÉ latte or cappuccino    12 oz (tall)    75 mg
Starbucks espresso    1 oz (1 shot )    75 mg
Generic espresso    1 oz (1 shot)    30-90 mg
generic instant coffee    8 oz    27-173 mg
generic decaffeinated coffee    8 oz    3-26 mg

For the Tea Drinkers  
brewed black tea,    8 oz    40-120 mg
Brewed green tea    8 oz    30-50 mg
decaffeinated black tea    8 oz    2 mg
Tazo Chai Tea latte Starbucks    16 oz (grande)    100 mg
Nestea    12 oz    26 mg
Snapple    16 oz    42 mg
Lipton Brisk iced tea    12 oz    10 mg

Soft drinks  
Coke    12 oz    35 mg
Pepsi    12 oz    38 mg
Jolt Cola    12 oz    72 mg
Mountain Dew    12 oz    54 mg
7-Up    12 oz    0 mg
Sierra Mist    12 oz    0 mg
Sprite    12 oz    0 mg

Energy drinks      
Red Bull    8.3 oz    80 mg
SoBe Essential Energy, orange or berry    8 oz    48 mg
SoBe No Fear    8 oz    83 mg

Desserts      
dark chocolate    1.45-oz bar    31 mg
milk chocolate    1.45-oz bar    11 mg
frozen yogurt or coffee ice cream    8 oz    50-60 mg
hot cocoa    8 oz    3-13 mg

Source: HealthNews.com

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