WEIGHT GAIN IN

PREGNANCY
Introduction

During pregnancy physiological, endocrine and

metabolic changes occur in the mother to
provide for the growth and development of the
fetus.

These changes lead to increase in the weight of

the mother and the fetus
 NORMAL WEIGHT GAIN
• Weight gain is not uniform throughout in pregnancy
• Weight falls in the 1st three months due to nausea,
vomiting and loss of appetite.

• Weight gain starts from 12 – 20 weeks when

nausea/vomiting stops and she eats freely

• Greatest weight gain in pregnancy occurs between 20 -

30 weeks. Also excess weight gain in this period is
associated with pre eclampsia.

• >30weeks diminishes

• 38 – 39weeks marked fall in the weight gain.

• Post partum - rapid weight loss between 4 – 10 days

then falls gradually at 250gm/week.
 NORMAL WEIGHT GAIN
Mean weight gain in pregnancy is 12.5kg
(10 – 16kg)
- 17 – 20% of pre pregnancy weight
Any weight again > 500mg /week is
abnormal
 Distribution of weight
gain in pregnancy
• Uterus 1kg
• Blood 1.5kg
• Breast 1kg
• Fliud,fat, 5kg
• Fetus 3 – 4kg
• Amniotic fluids 1kg
• Placenta 0.5kg
• < 45 kg is under weight
• > 90 kg is obese
• Poor weight gain < 9 kg
• Normal weight gain 9 – 16 kg
• Excess weight gain >16 kg
• Body/mass index:-
• < 20kg/m2 thin
• 20 -24kg/m2 normal
• 25 – 29kg/m2 over weight
• > 30kg/m2 obese
 CAUSES OF POOR
WEIGHT GAIN
Inadequate food and fluid in take
Hyperemesis gravidarium
Poor sleep ,HIV, cancer
Athlete
Poverty, crowded accommodation and
shared food
New food intolerance
 EFFECTS OF POOR
WEIGHT GAIN IN PREGNANCY
• Anaemia
• IUGR
• Preterm labour
• Infections
• Increased Perinatal mortality
 CAUSES OF EXCESS WEIGHT

• Obesity
• PET
• DM
• Multiple pregnancy
 EFFECTS OF EXCESS WEIGHT
GAIN IN PREGNANCY
Difficult abdominal palpations
Thrombophlebitis
FETAL MACROSOMIA
DYSTOSIA
UTI
PPH
 DIET DURING PREGNANCY
• Well balanced and adequate diet is
important
• Fetus is a parasite – takes all what is
required from the mother even at the
detriment of her general health
• The diet should contain adequate :-
• Protein, carbohydrate ,fat, fresh fruits and
fluids.
• vitamins
 MEGADOSES OF
VITAMINS &MINERALS
• Large doses of fat soluble vitamins –A,D. cause
birth defects

• Excess selenium & zinc - suppress immunity

• Fluoride - mottled teeth

• Zinc competes with iron

 VEGETARIANS
• Ovolactovegetarians milk,egg,fish,puoltry

• Lactovegetarians - milk and vegetables.

They need Ca,Fe, B co supplements.

- Vegans - Eat plants only. They also need

Ca,Fe, B co supplements

- Zen macrobiotics – Eat fruits only. They should

not get pregnant
 PRESENTATION

• HISTORY – nutritional, psychological

sports and food intolerance.

• Measure height ,weight, BP ,blood sugar,

ultrasound
 MANAGEMENT
• Preconception care :-
• for the underweight and obese

• Joint treatment by dietician, physician,

psychiatrist and the obstetrician to correct
weight before pregnancy
 ANTENATAL CARE
• Monitor fetus with :-
• fetal kick count, EFM, BIOPHYSICAL
profile and Doppler scans
• Joint management by physician, dietician
and OBGYN
 LABOUR CARE
• Team work by OB GYN,
NEONATOLOGIST,ANAESTHETIST
• Watch out for preterm labour , premature baby
and asphyxia in under nourished mothers
• Also expect high BP, PET, DYSTOSIA and
increase rate of operative deliveries in obese
patients.

•
 Post partum
• PPH
• INFECTION
• ENCOURAGE BREAST FEEDING
THANK YOU