facilitators and barriers to adoption of GWG recommendations by health care providers in their clinical practice;

  • Partner and family influences on GWG;

  • Influences of genetic factors, epigenetic events, and developmental programming on GWG;

  • How GWG affects birth outcomes, postpartum weight retention, and overweight and obesity in later life among adolescents and older women. Findings from these studies should be used to reevaluate the appropriateness of GWG recommendations for these women;

  • Determining whether maternal biomarkers such as leptin, adiponectin, and other markers of insulin sensitivity can be used to enhance clinical prediction of adverse birth outcomes and guide further interventions for women with GWG outside the recommended ranges. Data on relevant biomarkers should be made available through databases such as the Federal Human Nutrition Research and Information Management (HNRIM) System Database; and

  • Influences of psychological factors, such as depression, stress, social support, and attitude toward GWG on actual GWG.

The Department of Health and Human Services or other appropriate federal agencies should:

  • Track racial/ethnic and socioeconomic disparities in GWG and that the research community should conduct studies on how GWG affects birth outcomes, postpartum weight retention, and overweight and obesity in later life among women of different racial/ethnic and socioeconomic groups;

  • Collect nationally representative data on dietary intake, physical activity, and food insecurity among prepregnant, pregnant, and postpartum women, and report these data by prepregnancy body mass index (including all classes of obesity), age, racial/ethnic group, and socioeconomic status; and

  • Collect data on GWG among vulnerable populations.

REFERENCES

Abraham S., A. Taylor and J. Conti. 2001. Postnatal depression, eating, exercise, and vomiting before and during pregnancy. International Journal of Eating Disorders 29(4): 482-487.

Abrams B., S. L. Altman and K. E. Pickett. 2000. Pregnancy weight gain: still controversial. American Journal of Clinical Nutrition 71(5 Suppl): 1233S-1241S.



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