BALTIMORE Before Aiesha Eddins got pregnant, she didn't give much thought to her diet.
"I ate whatever," said the 27-year-old Owings Mills, Md., woman. "We ordered take-out."
But when she weighed in at 220 pounds during her initial prenatal visit, she quickly earned a spot at the Johns Hopkins Hospital's Nutrition in Pregnancy Clinic, launched in December to counsel and treat obese women. The clinic has around a dozen patients but already is expanding.
An estimated one in five pregnant women are obese, according to the U.S. Centers for Disease Control and Prevention, an epidemic according to some doctors who have begun to buck conventional ideas about "eating for two." They now recommend healthy diets, little or no weight gain and even bariatric surgery for obese women before they get pregnant.
Obese pregnant women are at increased risk of miscarriage, high blood pressure, diabetes, pre-term delivery, stillbirth, cesarean section and other problems. Their babies, which are harder to see on ultrasounds, are more likely to be obese and diabetic and have other maladies.
Conventional advice for these women since 2009 has been to gain 11 to 20 pounds, reflecting guidance from the Institute of Medicine, the influential federal advisory panel. Normal weight women are told to gain 25 to 35 pounds.
Most doctors generally stick to the guidance and treat obesity complications, said Dr. Janice Henderson, an obstetrician for high-risk pregnancies at
Eddins was counseled to eat more fruits, vegetables and whole grains. Now seven months pregnant, she's lost 20 pounds.
"Over the course of a pregnancy they learn a lot that we hope will have a carry-over effect postpartum both for themselves, their child, and perhaps even spill over to other family members," Henderson said about the women in the Hopkins clinic. "Imagine if we don't begin to address this problem what the next generation or the generation after that will look like with respect to obesity rates."
Henderson said some women gain too much weight in pregnancy, but most already are overweight. Federal statistics show that nearly a third of women of reproductive age are obese, and the numbers are higher among minorities.
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