For those with no attention span (and can’t read past a twitter title), the findings were 

• the higher your BMI, (underweight–>normal–>overweight–>obese), and
• the more your weight gain past recommendations during pregnancy,

the higher your chance of high blood pressure during pregnancy. (High blood pressure during pregnancy is bad.)

Terms:

BMI= Body mass index. To calculate yours, here is a link from the US department of health  :http://www.nhlbisupport.com/bmi/bminojs.htm

PPBMI= Your prepregnancy BMI

IOM= Institute of Medicine.  It has guidelines recommending how much you should gain.  Those will be posted in another blog, but if you are normal weight, you average weight gain during pregnancy should be around 30 pounds, if obese around 15 pounds.

Study: American Journal of Perinatology Jan 2011

• Evaluated new Institute of Medicine weight gain guidelines within each PPBMI category
• Patients with singleton term deliveries
• Women without history of  heart disease, diabetes, or pregnancy high blood pressure
• Pregnancy high blood pressure rates were compared overall and within each PPBMI group
• Looked at women gaining less than recommendations, within recommendations, and above recommendations

FINDINGS:

• High blood pressure during pregnancy was higher when your prepregancy BMI was higher (5.0%, 5.4%, and 10.8% for less than, within, and above recommendation groups, respectively ( P < 0.001).
• Above recommended weight gain resulted in higher high blood pressure incidence within each PPBMI category (underweight 7.6%, normal weight 6.2%, overweight 12.4%, and obese 17.0%), reaching statistical significance in all but the underweight PPBMI group.
• Excessive weight gain above established guidelines was associated with increased rates of high blood pressure. 
• Regardless of PPBMI, women should be counseled to avoid excessive weight gain during pregnancy.

So if you are considering getting pregnant, or you are pregnant, look at your BMI and weight gain.  It is important for your health and your pregnancy.  In general, as a plastic surgeon who specializes in the mommy makeover, I see women who don’t fare well with pregnancy.  Weight gain is part of that issue.

The number of cases is at the highest level since 1958.

Why do we care?

• Case rates are highest in infants
• Adolescent and teens follow close behind
• 12% of cases required hospitalization
• 8 deaths have been reported, all in babies less than 2 months of age, and none had been vaccinated yet.

Whooping cough is spread by inhaling respiratory droplets (ie it gets into the air you are breathing) and is highly contagious.  On average they think most patients infect 12 other people!  Whooping cough in adults does not have the severe whooping cough characteristic of infants and young children, therefore it frequently goes undiagnosed.

Infants are very vulnerable.

Infants are protected for the first few months of life from maternal antibodies during gestation.  Unless recently immunized though, most pregnant women have little immunity to pertussis, so they are not giving sufficient protective antibodies to their fetus.  As a result, the California Department of Public Health is recommending

• all women of childbearing years be vaccinated with Tdap. (Tetanus, Diptheria, Acellular Pertussis) Pregnancy is not a contraindication to vaccination, though usually women are vaccinated in the 2nd /3rd trimester or postpartum. 
• Anyone in close contact with infants– family members, caregivers, and health workers– should be vaccinated at least 2 weeks before contact.

Provide a cocoon of safety for your infant and your family. The first dose of DTaP is given at 2 months of age, but may be given as early as 6 weeks to provide protection earlier in life.

Findings?

They looked at 43000+ women aged 15-49 who were pregnant with a single fetus.  The women’s exercise was walking jogging, biking, weight training, aerobics, etc.  They averaged 6 times a month for the first half of pregnancy, and then once a week until week 30. 

The average weight of the infants at birth was 3,677 grams (8 pounds. Ouch!), and those who exercised during pregnancy did not have a significant effect on birth weight.

BUT, they did find an association with BMI. 

What is BMI? BMI is body mass index, to do it in US measurements, it is 703 x weight (lb)/ height (inches) squared.  BMI 18.5-23.9 is normal, 24-29.9 is overweight, and greater than 30 is obese.

The prepregnancy average BMI of the women in the study was 24. Fleten’s team found each unit increase in the mother’s BMI was associated with 20 grams (0.70 ounces) heavier birth weight.  So an increase in BMI of 5 units — 29 versus 24 — would cause a birth weight increase of 103 grams (3.63 ounces).

The Norwegian doctors suggest doctors focus on preventing or treating overweight and obese women of childbearing age to help reduce the risk of giving birth to babies who weigh too much. (OUCH!)

SOURCE: Obstetrics and Gynecology, February 2010

http://bizymoms.com/palo-alto/surgery/mommy-makeover-palo-alto.php