For one Ohio mom-to-be, a years-long struggle to lose weight has become even more urgent.
Jeneen Bufford, 32, had bounced from one fad diet to another, never dropping as many pounds as she wanted. She lost 80 of her 320 pounds through a boot camp program, but later gained back 35. Now expecting a baby in December, Bufford worries about all the extra pounds.
“With me being very overweight, I definitely want to make sure I have a healthy pregnancy,” Bufford told NBC News. “I really don’t want to cause any harm to my child because of any choices that I’ve made.”
Bufford has a reason to be concerned. A recent study published in JAMA found the risk of extremely premature birth -- babies born between 22 and 27 weeks -- rose rapidly with increasing maternal weight.
Women with a body-mass index between 30 and 35 were 58 percent more likely than those at a healthy weight to deliver an extremely premature baby, a team of U.S. and Swedish researchers found after examining the medical and delivery records of 1,599, 551 Swedish moms. Pregnant women with a BMI between 35 and 40 were twice as likely as normal-weight moms to have an extremely premature baby, while those with BMIs of 40 or greater were nearly three times as likely to deliver an extremely premature baby.
“When a baby is born earlier than it should be born, the potential for all the organs not being fully developed is increased,” said Karen Cooper, director of Healthy Expectations, a program at the Cleveland Clinic that helps women lose weight before they become pregnant. The program also helps obese pregnant women such as Bufford make healthier lifestyle choices so they might minimize the risks to their babies.
“When it comes to being obese and being pregnant, the risk factors for things going wrong multiply very quickly,” Cooper told NBC News. “Along with that comes gestational diabetes, hypertension, and preeclampsia, which can eventually lead to eclampsia, which is a condition where seizures occur.”
A premature baby may need a ventilator to help with breathing and nutrients fed through an IV tube, said Dr. Sandra McCalla, director of obstetrics at the Maimonides Medical Center. Further, prematurity can put a baby at risk for future problems, McCalla said.
More than half of American women of reproductive age are overweight or obese, said Cooper. But dieting during pregnancy is not the solution to maternal obesity.
“We just really encourage them to have a healthy lifestyle,” Cooper said. “We put together exercise activities per the individual mom and a calorie plan specific to the mom to have them gain an appropriate amount of weight.”
That’s where the surprise may come in for some women.
“Someone who has a body mass index between 19 and 24.9 has been encouraged to gain between 25 and maybe 35 pounds,” Cooper said. “When someone is overweight or obese, though, the amount of weight gain that is recommended is reduced. With a body mass index of 30 or higher the recommendation is a weight gain of 11 to 20 pounds.”
For Bufford, the changes have gone further than just counting calories.
“During my pregnancy my goal is to make sure that I eat enough fruits and vegetables and limit my grains,” she told NBC News. “And also to incorporate some protein as well and dairy.”
Ultimately, Bufford hopes the changes will pay off with a healthy baby.
“Now that I’m pregnant it’s no longer about me, it’s about my child,” she said. “I want my baby to be 100 percent healthy, 10 fingers, 10 toes and no internal problems whatsoever.”
First published September 20 2013, 7:36 AM