Rate of Weight Gain On the whole, about 0.5 to 2.0 kg (1.1 to 4.4 lb) is a target for average weight gain during the first trimester for all pregnant women.38 Thereafter, the target for average wei... ght gain per week is 0.5 kg (1 lb) for underweight and normalweight women, 0.3 kg (0.6 lb) for overweight women, and 0.23 kg (0.5 lb) for obese women. No scientific justification exists for routinely limiting weight gain to lesser amounts. Moreover, an individual woman who needs to gain more should not have unrealistic patterns imposed on her. It is only unusual patterns of gain, such as a sudden sharp increase in weight after the twentieth week of pregnancy that may signal abnormal water retention, which should be monitored closely, especially if it occurs in conjunction with blood pressure elevation and proteinuria. Conversely, an insufficient or low maternal weight gain during the second or third trimester increases the risk for intrauterine growth retardation.41 Weight Gain and Sodium Intake A moderate amount of dietary sodium is needed for two essential reasons: 1. It is the major mineral required to control the extracellular fluid compartment. 2. This vital body water is increased during pregnancy to support its successful outcome. Current practice usually follows a regular diet with moderate sodium intake, 1.5 to 2.3 g/day, with light use of salt to taste.42 Limiting sodium beyond this general use is contrary to physiologic need in pregnancy and is unfounded. The NRC and professional obstetric guidelines have labeled routine salt-free diets and diuretics as potentially dangerous.3-5 Maintaining the needed increase in circulating blood volume during pregnancy requires adequate amounts of sodium and protein, as well as adequate fluid intake to prevent dehydration and possible premature contractions [Show More]
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