- Episode Written by : Kyla Freeman, Rural Family Medicine PGY2
- Episode Reviewed by : Virginia Clark, FP practicing rural and urban obstetrics
- Hosts : Kyla Freeman (FM-PGY2), Patricia Massel (FM-PGY2), Caitlin Blewett (MS4)
- Episode Art : Aikansha Chawla
In today’s episode we explore weight, diet, and exercise. We review the complications of BMIs outside of the normal range, the weight gain recommendations by BMI class, and considerations regarding supplements to reduce the risk of adverse outcomes. When discussing diet we cover everything from “how much should our patient’s be eating anyway” to which supplements to be advising and which foods to recommend avoiding. We finish off with a review of the exercise recommendations in pregnancy – what are they and how do we get people to engage safely?
Helpful Resources – Weight Gain
- Healthy Pregnancy Weight Gain (Alberta Health Services) https://www.albertahealthservices.ca/assets/info/hp/hcf/if-hp-hcf-hpwg-information.pdf
- Pregnancy Weight Gain Tracker https://www.healthyparentshealthychildren.ca/resources/tools/weight-gain-calculator
- Obesity Canada Website (not OB specific) https://obesitycanada.ca/
Helpful Resources – Diet
- The Sensible Guide to a Healthy Pregnancy (Gov. of Canada) https://www.canada.ca/content/dam/phac-aspc/documents/services/health-promotion/healthy-pregnancy/64-03-16-1758-Sensible%20Guide%20to%20Healthy%20Pregnancy-EN-Web-final-v3.pdf
- Food Safety for Pregnancy Women (Gov. of Canada) https://www.canada.ca/en/health-canada/services/food-safety-vulnerable-populations/food-safety-pregnant-women.html
- Prenatal Nutrition Guidelines for Health Professionals – Background on Canada’s Food Guide (Gov. of Canada) https://www.canada.ca/en/health-canada/services/food-safety-vulnerable-populations/food-safety-pregnant-women.html
- Iron in Foods (HealthlinkBC) https://www.healthlinkbc.ca/healthy-eating-physical-activity/food-and-nutrition/nutrients/iron-foods
- Canada Food Guide – Servings (Gov. of Canada) https://publications.gc.ca/collections/Collection/H164-38-1-2007E.pdf
Helpful Resources – Exercise
- PARmed-X for Pregnancy (CSEP) https://vancouver.ca/files/cov/par-q-plus-form-for-pregnancy-before-exercising.pdf
Helpful Resources – General
- Pregnancy (Gov. of Canada) https://www.canada.ca/en/public-health/services/pregnancy.html
- Obesity Canada website (non-pregnancy specific) https://obesitycanada.ca
- Pregnancy Info (SOGC) https://www.pregnancyinfo.ca/your-pregnancy/healthy-pregnancy/healthy-eating/
- Healthy Parents Healthy Children Website (Alberta Health Services) https://www.healthyparentshealthychildren.ca
- Acute Care of at-Risk Newbonrs (ACoRN) Neonatal Society. First Edition ACoRN : Acute Care of at-Risk Newborns. Edmonton, AB: McCallum Printing Group, Inc;2012: pp. 7-8 & 8-4.
- Adesegun D, Cai C, Sivak A, Chari R, Davenport MH. Prenatal exercise and pre-gestational diseases: A systematic review and meta-analysis. J Obstet Gynaecol Can. 2018;41(8):1134-1143.e17. doi:10.1016/j.jogc.2018.10.007.
- American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics. Anemia in Pregnancy: ACOG Practice Bulletin, Number 233. Obstet Gynecol. 2021 Aug 1;138(2):e55-e64. doi: 10.1097/AOG.0000000000004477. PMID: 34293770.
- Barrington KJ, Sankaran K, Canadian Pediatric Society, Fetus and Newborn Committee. Guidelines for detection, management, and prevention of hyperbilirubinemia in term and late preterm newborn infants. Paediatr Child Health. 2007;12(Suppl B):1B-12B. Accessed January 2, 2022. https://cps.ca/documents/position/hyperbilirubinemia-newborn
- Berger H, Gagnon R, Sermer M. Guideline No. 393-Diabetes in pregnancy. JCOG.2019;41(12).1814-1825. https://doi.org/10.1016/j.jogc.2019.03.008
- Bo K, Artal R, Barakat R, Brown W, Davies GA, et al. Exercise and pregnancy in recreational and elite athletes: 2016/20117 evidence summary from the IOC expert group meeting, Lausanne. Part 5. Recommendations for health professionals and active women. Br J Sports Med. 2018. 52. 1080-1085. doi:10.1136/bjsports-2018-099351
- Bo K, Artal R, Barakat R, Brown W, Davies GA, et al. Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 1 – exercise in women planning pregnancy and those who are pregnant. Br J Sports Med. 2016; 50. 571-589. doi:10.1136/bjsports-2016-096218
- Govindappagari S, Newman RA, Burwick RM. Iron-deficiency anemia in pregnancy and the role of intravenous iron: Anemia in pregnancy should be treated due to its connection to adverse maternal and neonatal outcomes. Contemporary Ob/gyn. 2021;66(7): 20-24. https://ucalgary-primo.hosted.exlibrisgroup.com/permalink/f/1p0s7n7/TN_cdi_gale_infotracacademiconefile_A669928246
- Health Canada. Eating well with Canada’s food guide. https://publications.gc.ca/collections/Collection/H164-38-1-2007E.pdf. Accessed January 2, 2021.
- HealthyParentsHealthyChildren. Alberta Health Services. https://www.healthyparentshealthychildren.ca. Updated 2020. Accessed October 11, 2021.
- Maternal-Fetal Medicine Committee. No. 367-2019 Canadian guidelines for physical activity throughout pregnancy. J Obstet Gynaecol Can. 2018;40(11):1528-1537. https://doi.org/10.1016/j.jogc.2018.07.001
- Maternal-Fetal Medicine Committee. Guideline No. 391-Pregnancy and maternal obesity Part 1: pre-conception and prenatal care. J Obstet Gynaecol Can. 2019. 41(11). 1623-1640. https://doi.org/10.1016/j.jogc.2019.03.026
- Maxwell C, Gaudet L, Cassir G, Nowick C, McLeod LN, Jacob CE, Walker M. Guideline No. 391-Pregnancy and maternal obesity part 1: Pre-conception and prenatal care. J Obstet Gynaecol Can. 2019;41(11):1623-1640. doi:10.1016/j.jogc.2019.03.026.
- Moore A, Mundle W, O’Connor D, Ray J, Van den Hof M. SOGC clinical practice guideline No. 324 : Pre-conception folic acid and multivitamin supplementation for the primary and secondary prevention of neural tube defect and other folic acid-sensitive congenital anomalies. J Obstet Gynaecol Can.2007; 37(6):534-549. https://www-clinicalkey-com.ezproxy.lib.ucalgary.ca/#!/content/journal/1-s2.0-S1701216315302309
- O’Connor DL, Blake J, Bell R, Bowen A, Callum J, Fenton S, Gray-Donald K, et al. Canadian consensus on female nutrition: Adolescence, reproduction, menopause, and beyond. J Obstet Gynaecol Can. 2016;38(6):508-554.e18. doi:10.1016/j.jogc.2016.01.001.
- O’Malley GF, O’Malley R. Iron poisoning. Merck Manual Consumer Version. https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning. Updated 2021. Accessed December 4, 2021.
- Park CK, Timm V, Neupane B, Bayene J, Schmidt LA, McDonald S. Factors associated with women’s plans to gain weight categorized as above or below the national guidelines during pregnancy. J Obstet Gynaecol Can. 2015;37(3):225-235. doi:10.1016/S1701-2163(15)30308-X.
- PARmed-X for pregnancy: Physical activity readiness medical examination. Canadian Society of Exercise Physiology. https://vancouver.ca/files/cov/par-q-plus-form-for-pregnancy-before-exercising.pdf. Published 1999. Accessed October 13, 2021.
- Polsky JY, Gilmour H. Health reports: Food insecurity and mental health during the COVID-19 pandemic. Statistics Canada. https://www150.statcan.gc.ca/n1/pub/82-003-x/2020012/article/00001-eng.htm. Published 2020. Accessed December 4, 2021.
- Pregnancy Info. The Society of Obstetricians and Gynaecologists of Canada [SOGC]. https://www.pregnancyinfo.ca/your-pregnancy/healthy-pregnancy/healthy-eating/. Updated 2021. Accessed December 4, 2021.
- Society of Obstetricians and Gynecologists of Canada [SOGC]. Obesity. In: Course manual: Advances in labour and risk management. 27th ed. Canada. SOGC; 2020-2021:543-558.
- The Foundation for Medical Practice Education. Anemia in adults. Practice based small group learning program. 2017;25(10):1-19. www.fmpe.org.
- Wilson RD. Pre-conception folic acid and multivitamin supplementation for the primary and secondary prevention of neural tube defects and other folic acid-sensitive congenital anomalies. J Obstet Gynaecol Can.2015;37(6):534-549. doi:10.1016/S1701-2163(15)30230-9.