Connect
MJA
MJA

Adding weight to preconception care

Marc J N C Keirse
Med J Aust 2009; 191 (8): . || doi: 10.5694/j.1326-5377.2009.tb02874.x
Published online: 19 October 2009

Excessive maternal weight adversely affects all aspects of pregnancy and childbirth

Weight and weight gain in pregnancy used to be an obstetric obsession, if not an oppression. Belief that weight restriction could prevent pre-eclampsia made scales the most feared instruments in antenatal clinics,1 causing some women to resort to fasting before their next appointment. Nearly 20 years ago, the routine use of scales started to diminish, in the same way as it had begun — without good evidence.1 Attention shifted to the weight of the offspring, and achieving birthweights within the 3000–4000 g bracket, which are associated with better perinatal outcomes.2 Evaluations of the resulting guidelines for weight gain in pregnancy2 (recently revised)3 also centred on birthweight, with less attention to more substantive perinatal and infant outcomes.4 The evaluations also showed that only a minority of women achieve an ideal weight gain;4 many gain more than is recommended, and excessive gain is most frequent in those who are overweight already.4


  • Flinders University, Adelaide, SA.


Correspondence: marc.keirse@flinders.edu.au

  • 1. Green J. Diet and the prevention of pre-eclampsia. In: Chalmers I, Enkin M, Keirse MJNC, editors. Effective care in pregnancy and childbirth. Oxford: Oxford University Press, 1989: 281-300.
  • 2. Institute of Medicine. Committee on Nutritional Status during Pregnancy and Lactation. Nutrition during pregnancy. Part I: weight gain. Washington, DC: National Academy of Sciences, 1990.
  • 3. Institute of Medicine and National Research Council. Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: The National Academies Press, 2009. http://www.nap.edu/catalog/12584.html (accessed Sep 2009).
  • 4. Olson CM. Achieving a healthy weight gain during pregnancy. Annu Rev Nutr 2008; 28: 411-423.
  • 5. Callaway LK, O’Callaghan MJ, McIntyre HD. Barriers to addressing overweight and obesity before conception. Med J Aust 2009; 191: 425-428.
  • 6. Jeffries K, Shub A, Walker SP, et al. Reducing excessive weight gain in pregnancy: a randomised controlled trial. Med J Aust 2009; 191: 429-433.
  • 7. Norman RJ, Clark AM. Obesity and reproductive disorders: a review. Reprod Fertil Dev 1998; 10: 55-63.
  • 8. Cameron AJ, Welborn TA, Zimmet PZ, et al. Overweight and obesity in Australia: the 1999–2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Med J Aust 2003; 178: 427-432. <MJA full text>
  • 9. Ramachenderan J, Bradford J, McLean M. Maternal obesity and pregnancy complications: a review. Aust N Z J Obstet Gynaecol 2008; 48: 228-235.
  • 10. Villamor E, Cnattingius S. Interpregnancy weight change and risk of adverse pregnancy outcomes: a population-based study. Lancet 2006; 368: 1164-1170.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.