Beginning a diet and exercise program around the start of their second trimester helped some overweight and obese women limit their weight gain during pregnancy, but did not lower the risk of complications such as gestational diabetes or high blood pressure, a new study says.
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More than half of pregnant women in the United States are overweight or obese when they conceive, which increases the risk of health problems for the women and their children, The New York Times reported.
In an effort to find ways to tackle this problem, the U.S. National Institutes of Health-funded a trial that included 1,150 overweight and obese women at seven clinics nationwide.
On average, the women in the diet and exercise program had four pounds less weight gain than those in the control group, and were 48 percent less likely to exceed the U.S. Institute of Medicine's recommended amount of pregnancy weight gain, The Times reported.
However, 68.6 percent of women in the diet and exercise group exceeded the recommended amount of weight gain, compared to 85 percent of women in the control arm, and the rate of major pregnancy complications was the same in both groups, according to the study in the journal Obesity.
The results show that lifestyle changes can help overweight and obese women limit their pregnancy weight gain, but also suggest that more significant lifestyle changes may be needed before they conceive, according to study lead investigator Dr. Alan Peaceman, chief of maternal fetal medicine, Northwestern University Feinberg School of Medicine.
"This is a problem that is more important now than it's ever been, and it needs to be addressed," he told The Times. "We are going to have to start talking to women who are overweight or obese even before pregnancy and explain to them the risk of that weight on a potential pregnancy."
"One of our prevailing suspicions is that when we started with the intervention at the beginning of the second trimester it was already too late," Peaceman said. "It's possible the adverse outcomes were already influenced by weight gain before that time."
Other studies show that women should be helped to improve their health long before they get pregnant, according to Dr. Patrick Catalano, a senior research investigator at the Mother Infant Research Institute at Tufts Medical Center.
"My belief is that this has to be a life course approach -- it can't just be something we try when women are already 14 weeks into pregnancy," he told The Times.
"If you come into a pregnancy normal weight then statistically you're at a decreased risk for having a lot of complications. If the goal is to try to improve pregnancy outcomes for both the mother and her offspring, then we need to start early," Catalano said.
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