9
Nutritional Supplements
Î 4.4a. ES recommends pregnant women with overt or gestational
diabetes should follow the same guidelines for the intake of minerals
and vitamins as women without diabetes (1|⊕⊕
), with the exception
of taking folic acid 5 mg/d beginning 3 months before withdrawing
contraceptive measures or otherwise trying to conceive (see
Recommendation 1.4).
Î 4.4b. ES suggests the dose of folic acid be reduced to 0.4-1.0
mg/d at 12 weeks gestation and continued until the completion of
breastfeeding. (2|⊕⊕
)
Table 4. 2009 IOM Recommendations for Total Weight Gain
and Rate of Weight Gain During Pregnancy, by
Prepregnancy BMI
Prepregnancy BMI
Total Weight Gain
Rates of Weight Gain in Second
and Third Trimesters
a
Range, kg Range, lb
Mean (Range),
kg/wk
Mean (Range),
lb/wk
Underweight
(<18.5 kg/m
2
)
12.5-18 28-40 0.51 (0.44-0.58) 1 (1-1.3)
Normal weight
(18.5-24.9 kg/m
2
)
11.5-16 25-35 0.42 (0.35-0.50) 1 (0.8-1)
Overweight
(25.0-29.9 kg/m
2
)
7-11.5 15-25 0.28 (0.23-0.33) 0.6 (0.5-0.7)
Obese
(≥30.0 kg/m
2
)
5-9 11-20 0.22 (0.17-0.27) 0.5 (0.4-0.6)
a
Calculations assume a 0.5-2 kg (1.1-4.4 lb) weight gain in the first trimester.
