New IOM Guidelines Don’t Go Far Enough!
June, 2009: Headline: New IOM Guidelines Donâ€™t Go Far Enough. Obese pregnant women need to be monitored and numeric weight gains should not be the goal of managing these patients.
For over twenty years, doctors and other health care providers have managed their pregnant patients according to the recommendations of the American College of Obstetricians and Gynecologists which stated: â€œRegardless of how much women weigh before they become pregnant, gaining between 26-35 pounds during pregnancy can improve the outcome of pregnancy and reduce their chances of having the pregnancy end in fetal death.â€ The recent updated guidelines from the Institutes of Medicine (IOM), just out last week, are not much different from their 1990 recommendations. The IOM still recommends that obese pregnant women gain between 11 to 20 pounds during their pregnancy.
A new study, the first of its kind, challenged that doctrine as it pertained to obese pregnant women. The findings of this multicenter, randomized clinical trial have just been published in the June issue of The Journal of the National Medical Association.
Dr. Yvonne S. Thornton, MD, MPH, the lead investigator, followed more than 200 obese pregnant women over a period of seven years. The daily food intake of obese mothers in the control (unmonitored) group was according to conventional prenatal guidelines, which was â€œto eat to appetite.â€ However, obese mothers in the study (monitored) group were placed on a well-balanced, nutritionally monitored program, which included a daily food diary. The majority of the patients were over 200 pounds.
The findings showed that there were no fetal deaths, no growth-restricted infants, and fewer babies weighing more than 10 pounds. Moreover, the obese mothers in the monitored group gained less weight, had fewer cesarean deliveries, were less likely to develop gestational diabetes and retained less weight after they delivered.
The average weight gain in the control (unmonitored) group was 31 pounds compared to an 11-pound weight gain in the study (monitored) group. Twenty-three extremely obese patients actually lost weight during their pregnancy. This study concludes that rather than focusing on a numerical end-point with respect to weight gain in obese pregnant women, obstetricians should promote adherence to a monitored, well-balanced nutritional program during pregnancy.
Dr. Thornton is a Clinical Professor of Obstetrics and Gynecology and a Board-certified Maternal-Fetal Medicine specialist on the faculty of the New York Medical College in New York. Based on the findings of this well-designed study, obese pregnant women may be placed on a healthy, well-balanced monitored nutritional program during their pregnancy without the fear of adverse outcomes while achieving the optimal benefits of a healthier pregnancy. Dr. Thornton is also the national bestselling author of “The Ditchdigger’s Daughters” which later became a movie and was nominated for a CableACE Award.
This entry was posted on Tuesday, June 2nd, 2009 at 7:04 pm and is filed under Industry News. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.