Extra Pounds During and Between Pregnancies Can Pose Problems
- SATURDAY, April 19 (HealthDay News) — Pregnancy has long been
considered a kind of gastronomical free-for-all. After all, a pregnant
woman has to nourish two bodies with the food she eats, right?
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The problem is, the baby's nutritional needs are only around 300
calories a day, and extra weight gain can increase the risk of pregnancy
complications for both mother and child.
And, weight concerns don't stop after the baby is born, because extra
weight gain after pregnancy increases the risk of complications in
subsequent pregnancies, even if a woman never gains enough to be
considered overweight.
“Women think they have carte blanche to eat whatever they want during
pregnancy, but that's not a good idea,” said Dr. Miriam Greene, a clinical
assistant professor of obstetrics and gynecology at New York University
Medical Center and the author of the book, Frankly Pregnant: A Candid,
Week-by-Week Guide to the Unexpected Joys, Raging Hormones, and Common
Experiences of Pregnancy.
“If you eat for two, you'll end up with complications you didn't need
to take on. Eat what your appetite tells you to eat, and eat slowly, so
you can tell when you're full,” advised Dr. Marjorie Greenfield, an
obstetrician at MacDonald Women's Hospital at Case Medical Center,
University Hospitals in Cleveland, and author of the book, The Working
Woman's Pregnancy Book.
During pregnancy, an average-weight woman should gain about 25 to 35
pounds, according to Greene. “You don't want your weight gain to be less
than 15 or greater than 40,” she said.
But many women aren't heeding that advice. A recent report from the
Institute of Medicine (IOM) found that about one-quarter of American women
gain more than 40 pounds during their pregnancy. The IOM is currently
reviewing its guidelines on pregnancy weight gain and expects to issue new
guidelines during the summer of 2009.
In the meantime, the IOM recommends that women with a body mass index
(BMI, a ratio of weight to height) of less than 18.5 should gain 28 to 40
pounds during pregnancy, while women with an average BMI — 18.5 to
24.9 — should keep weight gain between 25 and 35 pounds. Overweight
women with BMIs of 25 to 29.9 should try to gain between 15 and 25 pounds
throughout their pregnancy, and obese women with BMIs over 30 need only
gain 15 pounds.
Gaining too much weight during pregnancy puts both baby and mom at risk
of complications, such as gestational diabetes and high blood pressure,
labor complications, stillbirth and delivery of a large-for-gestational
age baby, according to the March of Dimes.
Greene said about two-thirds of her patients manage to stay within the
guidelines. And those who don't are very disappointed at how hard the
weight is to get off afterward.
She recommends that her pregnant patients eat well-balanced diets and
that they don't give in to every food craving. “It's not healthy to gain
weight eating pints of ice cream,” she said.
Greenfield is also a fan of most exercises during pregnancy. Not only c
an exercise help you stave off pregnancy weight gain, it improves overall
well-being as well, she said.
“Pregnancy is a special time when a lot of women will take better care
of themselves to take care of the baby. It's a golden opportunity to take
care of yourself, and you may have an impact on your health and your
baby's health in the long run,” Greenfield noted.
And, it's not just during pregnancy that women have to be concerned
about extra pounds. A recent study found that every one or two point
increase in a woman's BMI between pregnancies translated to an increased
risk of gestational diabetes, high blood pressure and delivering a large
baby by 20 percent to 40 percent. Women who increased their BMI more than
three points between pregnancies had a 63 percent increased risk of
delivering a stillborn baby.
The increases in the risks of complications held true even if the BMI
changes didn't place a woman into the overweight or obese category, the
study found.
More information
To learn more about weight gain during pregnancy, visit the American Pregnancy Association.
Report: Language help better for patients at NY hospitals
NEW YORK - Two years ago, Aida Torres rushed her feverish daughter to the emergency room. Doctors at the Brooklyn hospital tried telling Torres that her mentally retarded daughter, Madayeli, needed surgery for an ovarian cyst, but the scared mother didn’t understand them because she doesn’t speak English.
Frustrated and desperate, the native of the Dominican Republic sought help from a Spanish-speaking hospital maintenance worker. He wasn’t able to help either; Torres eventually asked a friend to leave work to interpret.
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The New York Immigration Coalition and other groups released a report this week on the availability of language assistance at city hospitals for non-English-speaking patients — a vexing problem in a city where roughly 2 million people speak little or no English.
The report says that such help at hospitals seems to have improved since 2006, when state health officials began regulating communication between hospitals and their non-English-speaking patients, but more still needs to be done, particularly regarding languages such as Korean, Haitian Creole, Russian, Arabic and Bengali.
For people who don’t speak English, the language barrier makes it difficult for them to explain symptoms, understand doctors’ diagnoses and navigate the insurance system, advocates said. The barrier can lead to misdiagnoses and even death, they said. Mistaken amputations, sterilizations and abortions have resulted from such barriers, they said.
Forcing patients to rely on hand gestures or relatives, friends or other patients to translate medical information can lead to miscommunication, violates privacy laws and can traumatize, say, a child relaying to a parent that the parent has cancer.
“It is simply impossible to provide quality health care unless patients can communicate their symptoms clearly, understand their diagnosis and knowingly consent to medical procedures,” said Andrew Friedman, co-executive director of Make the Road New York, a civil rights organization that participated in the report.
The report, “Now We’re Talking,” was based on surveys conducted between October 2007 and February of this year of 617 patients who speak Spanish or Korean but not English. Officials stressed that the study wasn’t scientific and provided only a snapshot.
It showed that 79 percent of patients said they received help in their native language compared to the 29 percent who said during a survey before the 2006 regulations that they communicated with hospital staff in their native language.
Before the regulations, which require private and public hospitals in the state to provide skilled interpreters, translate important hospital forms into common languages and ensure patient care isn’t delayed because of language issues, it wasn’t uncommon for hospitals to tell non-English-speaking patients to bring their own interpreters.
According to the new report, only 5 percent of patients reported being told to bring their own interpreters.
“Hospitals have made real strides and have figured out how to communicate with Spanish speakers,” said Adam Gurvitch, the coalition’s director of health advocacy.
But there’s “a real disparity” when it comes to hospitals serving speakers of other foreign languages, he said.
“There’s some progress there, but not nearly enough,” he said.
Nisha Agarwal, a staff attorney with New York Lawyers for the Public Interest, which advocates for such patients, said language assistance in hospitals appears to have improved since 2006 and she doesn’t get as many calls from patients.
Claire Pospisil, a spokeswoman for the state Health Department, said the agency is constantly working to ensure that language assistance is provided to New Yorkers at hospitals.
She said the agency’s hospital complaint line receives more than 10,000 calls each year; of those calls, there were only 20 complaints about language translation in 2006 and 10 last year.
Rare liver disease kills 10 Afghans; wheat blamed
KABUL, Afghanistan - As many as 10 people have died in western Afghanistan from a rare liver disease believed to be caused by contaminated wheat, officials said Saturday.
At least 161 people were also hospitalized with Gulran disease although estimates were as high as 200 affected in Herat province, on the Iranian border, said Peter Graaff, resident representative of the U.N. World Health Organization.
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A toxic weed called charmak, which grows in the area, contains alkalines that affect the liver causing Gulran disease, which is named after the affected district in Herat. Graaff said the disease is not new but rare, and has killed as many as 10 people in recent weeks.
Abdul Hakim Tamana, the director of the Herat public health department, said 112 Gulran cases have been recorded in the province’s clinics, and six people died.
“It has spread all over Gulran district, including several villages,” Tamana said.
It was unclear exactly how the people became ill. The WHO is sending an epidemiologist from Geneva to Afghanistan next week to investigate.
Graaff said charmak may have contaminated wheat grown in the region, flour or other foods.
The Afghan Red Crescent Society received $14,000 to purchase new wheat to replace suspect supplies in the district as a precautionary measure, said Graziella Leite Piccolo, a spokeswoman in Kabul for the International Committee of the Red Cross.
Tamana said Gulran disease has affected people in the area over the past 40 years, and several people died in 1999 and 2001 from it.
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Associated Press writer Rahim Faiez contributed to this report.
Canada says chemical in hard plastic bottles may be unsafe
TORONTO - An ubiquitous chemical found in hard plastic water bottles, DVDs, CDs and hundreds of other common items came under increased pressure Friday when Canada said it’s potentially harmful and may ban its use in baby bottles.
Health Canada made the announcement shortly after a U.S. company said it would stop selling hard-plastic Nalgene water bottles made with bisphenol A because of growing consumer concern over whether the chemical poses a health risk.
Feds are looking into the dangers of lead in artificial turf
TRENTON, N.J. - The U.S. Consumer Product Safety Commission is looking into the possible health hazards of lead in artificial turf installed at schools, parks and stadiums across the country.
Two fields in New Jersey were closed this week after state health officials detected what they said were unexpectedly high levels of lead in the synthetic turf and raised fears that athletes could swallow or inhale fibers or dust from the playing surface.
CDC: Mounting illness reports linked to supplement
ATLANTA - Health officials are investigating more than 180 reports of illness in people who took dietary supplements containing toxic levels of the mineral selenium.
Last month, federal officials warned consumers about harmful doses of selenium — a mineral considered healthful in small amounts — in plastic bottles of liquid Total Body Formula and Total Body Mega Formula.