High Birth Weight: The New Adverse Outcome

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While pub­lic aware­ness of low birth weight and pre­ma­ture infants is becom­ing — at long last — inter­est­ing to the main­stream cul­ture and media, anoth­er phe­nom­e­non is begin­ning to shake the pro­fes­sion­al birthing world:  high birth weight. Because it is occur­ring in a more afflu­ent ele­ment of soci­ety, it is alarm­ing. This tells us that you can­not buy your way out of preg­nan­cy risks that are cre­at­ed by a seden­tary, tox­ic food life-style.

Here is the dilem­ma:

Nor­mal weight and some over­weight women who eat too much in preg­nan­cy tend to have babies who are, basi­cal­ly, already obese at birth. There­fore, these infants already have meta­bol­ic and car­dio­vas­cu­lar dys­func­tion. Babies born over 8 lbs. 14 oz. are at increased risk for Type 2 Dia­betes and heart dis­ease.

Inter­est­ing­ly, the Insti­tute of Med­i­cine  recent­ly issued new guide­lines on preg­nan­cy weight gain. After near­ly 20 years of adher­ing to the “nor­mal” weight gain being 25 to 35 pounds, the Insti­tute rec­og­nized that pre­na­tal BMI plays a role in how much weight gain is nec­es­sary for a healthy preg­nan­cy.

The evi­dence that under­lies this change demon­strates that gains greater than 22 pounds — for all clas­si­fi­ca­tions of pre­na­tal BMI — is the demarka­tion point for increased health prob­lems.  More infor­ma­tion on this is avail­able at:  New IOM Guide­lines.

We have known for a while now that obe­si­ty in preg­nan­cy puts moth­er and infant at risk for a num­ber of prob­lems from car­dio­vas­cu­lar, meta­bol­ic and immune dis­or­ders to pre­ma­tu­ri­ty, low birth weight, increased need for cesare­an birth and slow recov­ery. Add anoth­er one:  Obese new­borns with increased risk for heart and metab­o­lism prob­lems.

Ref­er­ence on weight gain and high birth weight:

Lud­wig DS, Cur­rie J. The asso­ci­a­tion between preg­nan­cy weight gain and birth­weight: a with­in-fam­i­ly com­par­i­son. Lancet. 2010 Sep 18;376(9745):984–90. Epub 2010 Aug 4.

A good ref­er­ence for issues sur­round­ing obese preg­nan­cy:

Led­dy MA et al. The Impact of Mater­nal Obe­si­ty on Mater­nal and Fetal Health. Rev Obstet Gynecol 2008;1(4):170–178.