Date of Graduation

1999

Document Type

Thesis

Degree Type

MS

College

Davis College of Agriculture, Natural Resources and Design

Committee Chair

M. Zafar A. Nomani

Committee Member

Hazel Hiza

Committee Member

Betty Forbes

Committee Member

Gary J. Wingenbach

Abstract

Historically, weight gain during pregnancy has been a topic of intense debate. During the 19th century, the mother was to “diet” to produce smaller babies, thereby avoiding early induction of labor. Excessive weight gain was thought to complicate labor, increase the incidence of eclampsia and preclampsia, and decrease the likelihood of successful breast feeding, in addition to a number of other complications (Cogley, 1983). In response to such debate, the Committee on Nutritional Status during Pregnancy and Lactation was formed, and subcommittees were appointed to focus on specific aspects of the overall subject. Consequently, guidelines for weight gain during pregnancy continue to be recommended. The current guidelines established by the Institute of Medicine (IOM) at the National Academy of Sciences recommend that most women gain 11.25 to 15.75 kg (25 to 35 pounds) during normal pregnancy. The first trimester of pregnancy, the mother should gain 3 to 5 pounds. Thereafter, the mother should gain approximately 1 pound per week for women with normal prepregnancy weight-for-height (Kolasa & Weismiller, 1997); this recommended weekly weight gain is slightly more than 1 pound for underweight women and slightly lower (0.7 pounds) for overweight women. In the 1990s, average weight gain during pregnancy was 25 to 30 pounds (Worthington-Roberts & Williams, 1993). Additional research is needed to determine the healthiest weight gain pattern during pregnancy. During each trimester of pregnancy, women experience a change in nutritional requirements. Energy requirement increases minimally in the first trimester, then rises rapidly during the second and third. In the first trimester additional energy intake for a pregnant woman is about 100 kcal/day. During the second and third trimesters, the recommended energy intake 1 for pregnant women is an additional 300 kcal/day. The recommendation for energy intake during the lactation period is about 500-600 kcal/day (Kolasa & Weismiller, 1997). Aside from nutrition, exercise plays an important role in the maintenance of a healthy life-style and controlling weight gain; as a result, exercise during pregnancy has become increasingly prevalent. The primary reasons most women exercise during pregnancy is to avoid excess weight gain or prepare for labor and delivery. After giving birth, many women want to return to their normal body weight as soon as possible. The physiological changes occurring during pregnancy and its association with weight gain are of great concern when dealing with exercise. The physiological changes include: increases in maternal blood volume, heart rate, cardiac output, and decreases in maternal systolic and diastolic blood pressure. Furthermore, there is an increase in maternal body weight and a marked increase in fat mass (Clapp, et al., 1992). As a result of the physiological changes, exercise during pregnancy becomes increasingly complex. Weight gain during pregnancy has been a particular concern among rural populations. Average total weight gain in pregnant rural women is as low as 13.2 pounds (6 kg) in developing countries such as Tanzania, but ranges from 22 to 35 pounds (10-16 kg) in developed countries (Moller, et al., 1989). Obstetrical practice in the United States has changed dramatically within the last decade. In fact, there has been a decline in the number of obstetrical practitioners, especially those serving remote rural populations. Rural women and women receiving Medicaid confront a variety of barriers when attempting to obtain perinatal care. In some rural areas, obstetrical care is practically unattainable (Rosenblatt, et al., 1990). According to Baron (1989), many women residing in rural West Virginia do not, for numerous reasons, seek early prenatal nutrition counseling or adequate prenatal care. Pregnant 2 women and pregnant teens, represent more than 50% of those who receive inadequate prenatal care, which is the lowest in the nation. Hospitalizations, resulting from poor health habits, inadequate prenatal care and various other risk factors result in public expenditures of millions of dollars each year. Therefore, if proper prenatal care were supplied to all communities, the number of healthier pregnancies would increase, and West Virginia would experience a reduction in state and federal healthcare costs

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