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Weight Matters

Maintaining body weight within a healthy range is an important part of good reproductive health. This term, healthy weight, refers to two aspects of weight: pre-pregnancy weight range and appropriate weight gain during pregnancy. Extremes of weight on either side, either very thin or obese, increase a woman's risk of pregnancy difficulty.

Reproductive hormones are critical to pregnancy success. Because these hormones are dependant on fat for their normal production and metabolism, body composition and fat stores directly effect their activity. Both very low and very high body fat stores, reflected in weight, can change the body's reproductive abilities. In addition, some chronic diseases are more likely to accompany higher or extremely low weights. Any pre-existing disease will add stress to pregnancy and may effect one's reproductive ability.

Assessing Weight
One effective tool used to assess pre-pregnant body weight is the Body Mass Index (BMI). BMI is used by health professionals to screen adults for their health risks related to weight. It is based upon a relationship between weight and height, excluding frame size and muscle mass. The 'ideal' BMI range, or that which carries the lowest health risk, is considered 19 to 25. For pregnancy, however, the recommended pre-pregnancy BMI range is 20-25. Note: the BMI can not accurately assess health risk based on a woman's weight during pregnancy or lactation. It also needs to be interpreted differently for those with high lean body weight (body builders, athletes). However, when used to assess pre-pregnancy weight status, BMI can help identify those with higher risks and suggest remedies.

Low Weight
A low pre-pregnant weight is defined as a BMI of less than 20. It can also be determined for a teenager who's body weight is 85 percent or lower of normal weight for age and height. Concerns for women, or teens, with excessively low weight include a possible decrease in their production of estrogen. Inadequate estrogen production will reduce a woman's fertility and can result in amenorrhea, or loss of the menstrual cycle, reduced calcium absorption and altered bone metabolism. Studies have also shown that very low body weight at the start of pregnancy increases a woman's risk of delivering a premature or low birth weight baby. For those with a low starting weight, weight gain before pregnancy and/or a higher weight gain during pregnancy can help reduce these risks.

High Weight
Interpretation of a high pre-pregnant body weight falls into 2 categories. A BMI between 26 and 29 is interpreted as carrying a slightly higher risk for health and pregnancy problems. Weight gain recommendations are lower for women in this BMI range. A BMI of 30 or higher is interpreted as carrying greater risk. Another interpretation for teens is a weight which is 30% or more higher than normal for age and height.

In general, a high BMI suggests increased risk for pre-existing chronic diseases, such as type 2 diabetes mellitus and hypertension, that will impact pregnancy. A closely related metabolic alteration is insulin resistance, which has been linked to fertility difficulties (polycystic ovary disease) and higher incidences of gestational diabetes. Further, obesity increases a woman's risks that cesarean delivery will be required.

For women who have a high pre-pregnant weight, weight loss is recommended but should be planned carefully and discussed with a physician. Improper dieting or rapid weight loss can interfere with the menstrual cycle and reduce fertility. If pregnancy does occur while a woman is following a severely restrictive diet, the early weeks of pregnancy may be effected. A general multivitamin-mineral supplement is recommended during pre-pregnancy weight loss to ensure nutrient stores remain high and to protect a developing embryo should pregnancy occur.

Weight Loss And Pregnancy
Intentional weight loss is NEVER advised during pregnancy. Cease a weight loss effort once pregnancy is established. Pregnancy hormones change the mother's metabolism and, as a result, production of ketones occurs more quickly in pregnant women than others when calories are restricted. Ketones are toxic to the fetus. For women who begin pregnancy at a high weight, weight gain goals or pregnancy are set lower. None-the-less, weight gain is always the objective. If a slower rate of weight gain is advised and cutting back calories is suggested during pregnancy, this should be done moderately and under the supervision of your physician.

Not all exercises or diets are suitable for everyone. Before you begin this program, you should have permission from your doctor to participate in vigorous exercise and change of diet. If you feel discomfort or pain when you exercise, do not continue. The instructions and advice presented are in no way intended as a substitute for medical counseling. The creators, producers, participants and distributors of this site disclaim any liability or loss in connection with the exercise and advice provided here.

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