Could I Be Pregnant and Overweight?

▷When with child, eat without reserve

In the old days, people used to believe that a pregnant woman should eat amply in order for the fetus to be healthy. It’s a belief that is hard to throw off even today.

Unfortunately, it’s also a belief that has no real scientific grounds. On the contrary, being overweight during pregnancy can lead to postpartum obesity, diabetes, high blood pressure, and toxemia. What’s more, it can pass on the gene for obesity to the baby.

Being overweight also impedes natural childbirth. CHA General Hospital recently conducted a study of 1,042 women who had given birth to their first child, and found that the percentage of mothers who had had caesarian sections was higher among those who had been overweight during pregnancy. For mothers whose body mass index (BMI) had been higher than 25, the ratio rose to as high as 52.4%.

There is no actual need to eat excessively. The World Health Organization (WHO) revealed that a woman’s body requires an extra 80,000 calories over the 40 weeks of pregnancy; this only comes to 260-300 calories per day.

In the first trimester, you don’t really need to take pains to eat well, unless you’re experiencing such acute morning sickness that nutrition becomes a problem. The Korean Nutrition Society recommends adding 150 calories per day to your regular diet in the first half of pregnancy, and 350 calories per day during the latter half. In practical terms, this only translates to supplementing one of the following each day:

- 1 glass of milk and 1 glass of juice

- 2 apples

- 1 1/2 roasted sweet potatoes

- 50g of peanuts

- 1 bunch of grapes

- 1 fried egg and 1 serving of yogurt

- 1 slice of whipping cream cake

- 1 glass of milkshake

- 1/2 portion of sushi

- 2/3 slice of pizza

- 1 sandwich

- 1 bowl of rice

▷Am I overweight?

You inevitably put on some weight when you’re pregnant. So a surprising number of women tend to dismiss the weight gain as natural.

▷During pregnancy, a woman gains a total of 11-12.5kg. The placenta, amniotic fluid, and extracellular fluid take up about 9kg of this weight, with fat taking up the rest. In the 8th through the 12th week, there is a weekly weight gain of 0.3kg, then the margin increases to 0.5kg thereafter. Adding on 1-3kg after giving birth is normal.

▷According to OBGYN doctors, 3 out of 10 women become overweight during pregnancy, gaining 15kg or more over their term. One or two of this number gain over 20kg, and it is by no means rare for an expectant mother to gain more than 30kg.

Doctors consider weight increases of over 25kg, or more than 4kg per month, as a sure sign of pregnancy obesity. In such a case, immediate consultation with a physician is vital.

--Put balance before quantity

Doctors warn that “expectant mothers who eat excessively often lack a sense of nutritional balance in their diet.”

For pregnant women, regular intakes of protein, calcium, and iron are particularly important. A “bun in the oven” requires an additional 30% of protein, 50% respectively of calcium, iron, and phosphorus, and 100% of folic acid.

The daily protein recommendation for an expectant woman is around 70g. Protein is the main component in producing blood and uterine tissue, and enables the necessary breast enlargement. It also composes the fetus itself, as well as the placenta. As you near the third trimester, the intake of animal protein becomes even more crucial; it is good to obtain 30% or more of your daily requirement from animal protein. Try to eat a cut of fish, an egg, or some tofu every day. However, too much protein can heighten the risk of premature birth, so limit your protein consumption to 25% of your total calorie intake or less.

The extra calcium requirement can easily be satisfied by drinking a glass of milk a day. But the necessary iron is hard to get from just the food you eat, so you should take an iron supplement in addition to your meals. A slight decrease in the amount of carbohydrates you eat is acceptable.

(Assistance from: Professor Park Yong-woo of the Family Medicine Department at Kangbuk Samsung Hospital, Professor Park Ji-hyun of the OBGYN Department at CHA Hospital, and Professor Park Yong-wan of the OBGYN Department at Severance Hospital)

Sang Hoon Kim corekim@donga.com