Experts Suggest Moms-to-be Should Be More Active

A pair of recommendations made by St. Louis-based researchers are challenging old notions about diet and exercise regimens for pregnant women.

"For too long, physicians have told patients to eat for two and not to move during pregnancy," says Raul Artal, M.D., chair of the department of obstetrics and gynecology at Saint Louis University School of Medicine. "I used to tell my patients to gain 30 pounds during a pregnancy. But I changed my recommendation when I noticed women are heavier than they used to be."

Terry Leet, Ph.D., a study author and associate professor of community health at Saint Louis University School of Public Health, said obstetricians and gynecologists need to do a better job of encouraging women with uncomplicated pregnancies to exercise.

"The message is not getting out that women should continue to exercise during pregnancy, at least at moderate intensity," Leet said. "Only one of every six pregnant women are meeting the current physical activity recommendation of 30 or more minutes of moderate physical activity on most, if not all, days of the week."

Under the Institute of Medicine current guidelines, expectant mothers of normal weight are encouraged to gain between 25 and 35 pounds during pregnancy. For moms who were underweight to start with, the guidelines say to gain up to 40 pounds. Those women who were overweight prior to becoming pregnant are told to gain between 15 and 25 pounds.

"Between 20 and 25 pounds is probably too much weight for most women, considering 60 percent of the population is overweight or obese," Artal said.

Instead of using a set guideline, Artal now makes his recommendation on weight gain after looking at the woman's current weight and the estimated weight of the baby.

"There's no reason to pack on the pounds. The cost of pregnancy is anywhere between 150 and 300 calories a day," Artal said. "To put that into perspective, 120 calories is a glass of milk."

Looking at data from more than 150,000 pregnant and non-pregnant women interviewed between 1994 and 2000, Saint Louis University School of Public Health researchers found that the pregnant women were not as physically active.

Artal attributed this lack of activity to old-fashioned thinking.

"The hesitance of obstetricians to recommend exercise to pregnant women is rooted in old-fashioned notions of pregnancy as a time of confinement," he said. "Pregnancy is an ideal time for behavior modification and not a time for confinement."

According to the researchers, only 16 percent of pregnant women were meeting the current physical activity recommendation in 2000. In addition, the percentage of pregnant women who said they exercised at a moderate or vigorous level was lower in 2000 than in any of the previous years. Brisk walking for 30 or more minutes at least five days a week is considered moderate exercise.

"Overall, this study has vital public health implications that can assist physicians to identify patients who are at high risk for inactivity during pregnancy," Leet said. "These women should be encouraged to begin moderate activities most, if not all days of the week, as long as medical or obstetric complications do not exist."