Q: My 26-year-old wife weighed only 38 kg before conceiving. Now she is in her seventh month and weighs only 42.5 kg. Her haemoglobin is 9.5 and her blood group is A-negative. What precautions have to be taken for the blood group and for her weight gain?

A:Normally, there is a steady gain in weight as pregnancy progresses but its rate depends on the nutritional status prior to pregnancy. Underweight women gain about 3 kg in the first trimester and then around a kg per week in the second and third trimesters. If a woman does not gain weight throughout pregnancy, complications such as a low-birth weight infant or premature delivery could occur. It is important that she increases her protein and calorie intake. As a general guideline, she must have breakfast daily and add protein containing foods to the menu, add a snack of fruits, milk, nuts etc. between meals to provide calcium, protein and minerals, increase the intake of items that are rich in good fats like nuts or fish and avoid the consumption of junk food and take daily exercise. Your wife is anaemic (low haemoglobin) and markedly underweight for her state of pregnancy. Please consult her obstetrician as she would require monitoring – both for her own and the baby’s well-being. Due to her Rh-negative blood group she would need anti-D injection if your blood group is Rh-positive.