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Study sets optimum weight-gain levels for Asians to ensure safe delivery
IF YOU are in the family way and are so skinny that the family is wondering how the baby will find space to grow inside you, you should gain 15.1 kg during the pregnancy for a healthy child. But if you are obese, then 7.6kg is all you should pile on. These are the figures arrived at following new research by KK Women’s and Children’s Hospital (KKH) and Duke-NUS Graduate Medical School.
Data on acceptable levels of weight gain is available for Caucasian mothers-to-be, but this is the first time that some benchmarks have been recommended for Asian women. The study, the first of its kind here, has indicated that optimum weight gain by a mother-to-be can make for a healthier delivery and avoid complications for her and her baby.
Dr Tan Thiam Chye, the study’s lead researcher and an obstetrician and gynaecologist at KKH, said: “Many pregnant patients ask how much weight they should expect to gain during pregnancy, and they’re usually
told to expect to put on between 12kg and 15kg.” The study thus indicates to women the acceptable and healthy amount of weight to gain, given their size.
And “size” is expressed in terms of their body mass index (BMI), which is an approximate measure of a person’s body fat based on height and weight. BMI is calculated by dividing one’s weight by the square of one’s height. A woman of normal weight – that is, with a BMI reading of between 18.5 and 23 – should ideally put on about 13kg; her overweight sister with a BMI of 23 to 27.5 should gain only about 10kg.
To come up with these benchmarks, Dr Tan, with Professor Truls Ostbye from Health Services and Systems Research at Duke-NUS Graduate Medical School, analysed data from 1,592 women who had gone to KKH for the first antenatal check-up in their first trimester between January and April 2008. They looked for trends in what these women weighed before pregnancy and how much they put on in the following months.
Their preliminary findings are that pre-pregnancy obesity, and inadequate or excessive weight gain during pregnancy could increase the mother and child’s risk of certain conditions and cause birth complications.
For example, pregnant women who do not put on enough weight are twice as likely to contract gestational diabetes; they are also three times more at risk of giving birth to babies with poor Apgar scores. The Apgar score is the result of a simple test done on newborn babies which reflects their state of health.
Dr Tan, who is also an assistant professor at Duke-NUS Graduate Medical School, said the study was still preliminary and that he is looking to start a follow-up study on how pregnancies can be managed more holistically. “But at this stage, the findings will give a good reason to remind pregnant women to manage their maternal weight gain in a holistic way,” he said.
Dr Peter Chew, a gynaecologist and obstetrician in private practice, said no hard and fast rule exists for mothers-to-be because hormonal changes make weight gain erratic. “However, pregnant women should not diet. If there’s excess weight gain, she should just cut down on carbohydrates and salt,” he said.
 Less is not always better
ALREADY eight months pregnant, Mrs Catherine Khoo has put on only 7kg. While she may be the envy of other mothers-to-be, her gain is far short of the ideal. According to the KK Women’s and Children’s Hospital and Duke-NUS Graduate Medical School study’s recommendations, Mrs Khoo, who had a body mass index of 17.6 before pregnancy, should ideally have put on 15.1kg.
While she did not encounter any major problems when she had her first child, she had to opt for an assisted delivery. Mrs Khoo, who gained 7kg during her first pregnancy too, said she was surprised to learn that less is not always better. She said: “I eat three meals a day, no different from my pre-pregnancy diet. My doctor also did not advise me to put on more weight. “She told me that I shouldn’t eat for two, not to double the portions and to eat healthily.”
Big is not always beautiful
WHEN Ms Nurhidayati Yahya, 28, became pregnant with her first child about two years ago, she put on 16kg. That was more than double the optimal weight gain of 7.6kg recommended for women like her, according to a new study conducted by the KK Women’s and Children’s Hospital and the Duke-NUS Graduate Medical School.
Ms Nurhidayati, who had a body mass index of 32 then, said she put on the extra kilos because of the size of the baby and a sedentary lifestyle. Although she did not encounter any adverse complications during her pregnancy, she had to undergo an emergency caesarean section as the baby, at 3.7kg, was too big.
Now four months pregnant with her second child, Ms Nurhidayati said she will watch her weight more closely. “I want to experience delivering a child naturally, so I’m exercising more,” she said. “A bigger baby will increase the chance of a caesarean section, so I’m going to try to keep it small.”
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