A primigravida is being monitored in her prenatal clinic for preeclampsia. What finding should concern her nurse?

Choice A reason: Woman shorter than 62 inches or 157 cm should not restrict her weight gain during pregnancy, as she may have a higher risk of delivering a low birth weight infant. She should follow the recommended weight gain guidelines based on her pre-pregnancy body mass index (BMI).

Choice B reason: Woman in early adolescence should not restrict her weight gain during pregnancy, as she is still growing and developing herself. She may need more calories and nutrients than an adult woman to support her own health and the fetal growth.

Choice C reason: Woman who was 30 lbs overweight before pregnancy should restrict her weight gain during pregnancy, as she may have a higher risk of developing gestational diabetes, hypertension, or preeclampsia. She should aim for a lower weight gain range than a woman with a normal BMI.

Choice D reason: Woman pregnant with twins should not restrict her weight gain during pregnancy, as she needs more energy and nutrients to support the growth of two fetuses. She should aim for a higher weight gain range than a woman with a singleton pregnancy.

Choice A reason: Normal weight women should gain 11.5 to 16 kg during pregnancy, according to the Institute of Medicine (IOM) guidelines. This is based on the body mass index (BMI) of 18.5 to 24.9 before pregnancy.

Choice B reason: Underweight women should gain 12.5 to 18 kg during pregnancy, according to the IOM guidelines. This is based on the BMI of less than 18.5 before pregnancy. Underweight women are at risk of having low birth weight infants, so they need to gain more weight to support fetal growth and development.

Choice C reason: Adolescents are encouraged to strive for weight gains at the upper end of the recommended scale, according to the IOM guidelines. This is because adolescents are still growing themselves and need extra nutrients and calories to meet their own needs and those of the fetus.

Choice D reason: In twin gestations, the weight gain recommended for a single fetus pregnancy should not be simply doubled. The IOM guidelines suggest that women with twin gestations should gain 16.5 to 24.5 kg if they have a normal weight before pregnancy, 14 to 22.5 kg if they are overweight, and 11 to 19 kg if they are obese.

Choice E reason: Obese women should gain at least 7 to 11.5 kg during pregnancy, according to the IOM guidelines. This is based on the BMI of 30 or more before pregnancy. Obese women are at risk of having complications such as gestational diabetes, preeclampsia, and cesarean delivery, so they need to limit their weight gain to avoid further complications.