Health care providers should plan on counseling sessions of more than 15 minutes and to reinforce the message throughout pregnancy rather than in a single discussion.
Recommendations issued earlier this year by the U.S. Preventive Services Task Force (USPSTF) urge health care providers to guide pregnant patients with effective counseling to help them maintain a healthy weight and prevent excess weight gain.
Gaining too much weight during pregnancy can lead to a higher risk of gestational diabetes, cesarean deliveries and high-birth-weight babies.
Counseling should focus on nutrition, physical activity, and lifestyle or behavior changes, and can take place during routine office visits or more formal programs. Health care providers should plan on counseling sessions of more than 15 minutes and to reinforce the message throughout pregnancy rather than in a single discussion, the USPSTF advised.
“The clinician’s role is to respectfully and consistently address healthy gestational weight gain. The clinician should use a patient-centered approach to encourage healthy eating and exercise habits during preconception, pregnancy and postpartum, and give patients the resources to succeed,” said Kara B. Knapp, M.D., an OB/GYN with Norton Women’s Care.
In 2015, almost half of all persons began pregnancy either overweight or obese, according to the USPSTF.
Obesity is such a common condition that the implications for pregnancy are often unrecognized, overlooked or ignored because there is a lack of evidence-based treatment options, the American College of Obstetricians and Gynecologists (ACOG), advised in a June 2021 practice bulletin.
Management of obesity should begin before pregnancy and continue through postpartum with involvement of obstetricians and nutritionists.
The USPSTF offered examples for health care providers with a range of counseling and exercise interventions.
|High intensity||Moderate intensity||Low intensity|
|Mode of delivery||Individual or group counseling in person, online or over the telephone||Individual or group counseling in person or over the telephone||Individual sessions|
||Part of usual antenatal care, or one to two brief extra sessions|
|Content||Counseling focused on nutrition, goal-setting, physical activity, and behavioral and social support strategies||Counseling focused on healthy eating and/or physical activity based on American College of Obstetricians and Gynecologists recommendations||Counseling focused on maintaining healthy weight, often including personalized graphs with weight gain guidance based on National Academy of Medicine recommendations.|
- Structured, supervised exercise classes
- One to three times per week (average, 45 to 60 minutes)
- Aerobic, resistance and flexibility exercises based on American College of Obstetricians and Gynecologists recommendations for exercise during pregnancy
- Free weights, resistance equipment or both
- Lifestyle Interventions for Expectant Moms
Weight gain recommendations during pregnancy
|Prepregnancy weight||Pregnancy gain with one baby||Twins|
|Body mass index (BMI) less than 18.5||28 to 40 pounds||50 to 62 pounds|
|BMI 18.5 to 24.9||25 to 35 pounds||37 to 54 pounds|
|BMI 25 to 29.9||15 to 25 pounds||31 to 50 pounds|
|BMI 30 or greater||11 to 20 pounds||25 to 42 pounds|