WASHINGTON — Eating for two? New guidelines are setting how much weight women should gain during pregnancy — surprisingly little if they're overweight or obese when they conceive.
The most important message: Get to a healthy weight before you conceive, say the Institute of Medicine's guidelines, the first national recommendations on pregnancy weight since 1990. It's healthiest for the mother — less chance of pregnancy-related high blood pressure or diabetes, or need for a Caesarean section — and it's best for the baby, too. Babies born to overweight mothers have a greater risk of premature birth and becoming overweight themselves.
That's a tall order, considering that about 55 percent of women of childbearing age are overweight and preconception care isn't common.
Once a woman is pregnant, the guidelines issued Thursday aren't too different from what obstetricians recommend, but they're not easy, considering about half of women fail to follow them today.
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Among the advice:
A normal-weight woman, as measured by body mass index, should gain between 25 and 35 pounds during pregnancy. A normal BMI, a measure of weight for height, is between 18.5 and 24.9.
An overweight woman — BMI 25 to 29.9 — should gain 15 to 25 pounds.
An obese woman — BMI of 30 or higher — should gain 11 to 20 pounds. This marks the first recommendation ever set for women so heavy.
An underweight woman, — BMI less than 18.5 — should gain 28 to 40 pounds.
What if a mom-to-be has gained too much? On average, overweight and obese women are gaining five more pounds than the upper limit.
But pregnancy is not a time to lose weight, stressed guidelines co-author Dr. Anna Maria Siega-Riz of the University of North Carolina, Chapel Hill.
"It's not, 'Hey, you gained enough, now you need to stop,' " Siega-Riz said. "Let's take stock of where you're at and start gaining correctly."