What type of hormonal changes are detected in pregnancy and how much weight should pregnant woman gain?

Despite that, body experiences hormonal imbalances and "hurricane of hormones" might cause some problems for an otherwise healthy woman. 

Pregnancy fully depends on hormonal balance and this process is studied by endocrinology; That’s why it's recommended for a pregnant woman to consult with obstetrician-gynecologist, as well as an endocrinologist to ensure prompt diagnostic and preventive studies. 

For pregnancy to progress normally, hormone balance is necessary. Primary hormone in the progression of pregnancy is considered to be estrogen and progesterone, albeit this doesn’t weakens the importance of other hormones.

Endocrinologist of the clinic “New Life” of National Center of Surgery, Nino Abesadze discusses the topic.

–Why should a pregnant woman make an appointment to consult with an endocrinologist?  

– No matter how asymptomatic and physiological may be the progression of pregnancy, health and healthy human is still a conditional notion! Pregnancy requires additional resources from the female body, therefore, each organ and system doubles the functions. Given the condition, a relatively labile (unsteady, unstable) system can easily deteriorate. For example, if a woman has chronic autoimmune thyroiditis and thyroid functioned normally before pregnancy, it might not be able to do so afterward due to an increase in pressure after pregnancy. That’s when hypothyroidism, i.e., thyroid hormone deficiency, manifests, which can end fatally if undiagnosed!

Same can be said about vitamin D deficiency that mostly progresses asymptomatically and can cause the development of osteoporosis after childbirth and rickets in children.

– What type of endocrinology tests are conducted for pregnant women?

– Every pregnant woman should undergo a thyroid function test, which is recommended to be conducted in pregnancy planning and upon pregnancy diagnosis. For your knowledge, thyroid dysfunction is quite common in the world. The risk of thyroid hormonal disbalance is high due to pregnancy traits. Thyroid of the pregnant woman should be more active compared to other people’s and frequently pregnant woman doesn't have such resources. The monitoring of pregnant women comprises a glucose screening-test in the 2^nd trimester. Albeit,  glucose taste might be ordered individually in the first trimester depending on the patient's clinical condition. Vitamin D level test is also necessary. Other specific tests are conducted depending on particular cases.

– Pregnancy and obesity.

–Fortunately, the idea that has been widespread in society for years, that pregnant women should eat for two, is in the past. Nowadays pregnant woman's awareness is significantly higher. Albeit, extra weight is quite frequent…

Pregnant woman’s obesity might be a primary trigger of the following complications:

• Fetal macrosomia;
• Gestational diabetes;
• Preterm labor;
• Develop preeclampsia (developing hypertension, i.e, high blood pressure during pregnancy).

It’s expected to increase the demand for food by 300 kcalories, equivalent to 1 slice of pizza or 1 scoop of ice cream.

–Body varies from person to person, but according to guidelines, how many kilograms does a pregnant woman have a “right” to gain? 

– According to recommendations of the American College of Obstetrics and Gynecology, as well as the U.S Institute of Medicine, women with normal body weight before pregnancy (body mass index from 18 to 25 kg/m2), should gain 11-16 kg at the end of the pregnancy. Thin women (body mass index < 18 kg/m2) – 12-18 kg, whereas overweight women (body mass index 25-30 kg/m2) – 5-8 kg. These indicators are considered the norm!

– In pregnancy, demand for vitamins is increased, and what is more important healthy nutrition or additional multivitamins?

– Yes, in pregnancy demand for vitamins and minerals increases. In vitamins, vitamin D, and vitamin B9 – folic acid is important.

In minerals, the following are particularly beneficial:

• Iron;
• Iodine;
• Calcium.

Whether a pregnant woman needs supplements or not depends on the particular case and endocrinologist and obstetrician-gynecologist make a decision individually.  

Adding prophylactic folic acid supplements on a routine basis is not recommended. This concerns iodine as well!

According to authoritative studies conducted in Georgia in recent years, prophylactic iodized salt turned out effective, and nowadays, it’s not necessary to prescribe iodine to a pregnant woman in every case. 

As for the iron, vitamin D, and calcium, it’s better to decide on the prescription of the supplements in correlation with clinical-laboratory findings. 

Body should absorb vitamin D in every way possible. Of course, medication should be prescribed by an endocrinologist, taking pills on your own, without recommendation from doctor-specialist, is not recommended! A doctor's permission is not necessary when you want to absorb this vitamin from sun rays, of course, during the recommended time of the day (midday sun is harmful to people who are and aren't pregnant). Albeit it’s a fact that absorption of the mentioned vitamin only by sun rays isn't effective for many people. 

Scientists link vitamin D deficiency to the following:

1. Skeletal system pathologies;
2. Rickets;
3. Osteoporosis after childbirth;
4. Infertility;
5. Polycystic ovary;
6. Excess weight;
7. Underweight fetus;
8. Preterm labor;
9. Prolonged bleeding after childbirth;
10. Gestational diabetes;
11. Asthma in children and so on.

Wish you health!