Table 2-2 Recommended Total Weight Gain Ranges for Pregnant Women a,b

Prepregnancy

Recommended Total Gain

Weight-for-Height Category

lb

kg

Low (BMIc <19.8)

28–40

12.5–18

Normal (BMI of 19.8 to 26)

25–35

11.5–16

High (BMI >26.0 to 29.0)

15–25

7.0–11.5

Obese (BMI >29.0)

≥15

≥7.0

a Adapted from the Institute of Medicine's Nutrition During Pregnancy. 10

b For singleton pregnancies. The range for women carrying twins is 35 to 45 lb (16 to 20 kg). Young adolescents (<2 years after menarche) and African-American women should strive for gains at the upper end of the range. Short women (<62 in, or <157 cm) should strive for gains at the lower end of the range.

c BMI = body mass index.

The dispensing of supplements, however, is not considered a satisfactory substitute for a well-balanced diet or for taking steps to improve access to food.10

Energy

Pregnant women need a sufficient intake of energy to support recommended weight gain. "Women who are thinner before pregnancy tend to have babies that are smaller than those of their heavier counterparts with the same gestational weight gain" (p. 8).10 Thus, women who enter pregnancy with low weight for height may need to devote extra attention to achieving adequate weight gain to reduce their risk of delivering low-birth-weight babies.

Screening for factors that may interfere with adequate weight gain is recommended for all pregnant women, as is the monitoring of weight gain over the course of pregnancy.

Nutrition in Complicated Pregnancies

The combination of pregnancy and a health problem often leads to complex nutritional problems that require the attention of a specialized team. For example, pregnancy makes it more important (and more



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