dations for (1) the health of the mother, particularly for women who are overweight, underweight, older, adolescent, or short in stature; (2) infant and child health; and (3) other metabolic processes that may affect the in utero environment.

Another concern that has frequently been raised by researchers and practitioners is the difference between BMI categories used in the IOM (1990) report and those used in the report Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults from the National Heart, Lung, and Blood Institute (NHLBI, 1998) in cooperation with the National Institute of Diabetes and Digestive and Kidney Diseases, which are based on a report from the World Health Organization (1995). This is a problem for practitioners as well as for researchers. Most importantly, despite the effort made to publicize the recommendations of the IOM (1990) report, including the development of a guide to assist the medical profession to implement these guidelines (IOM, 1992), many health care providers have not used these guidelines and many women have not followed them (Abrams et al., 2000).

SETTING THE STAGE FOR REVISING THE GUIDELINES

In response to such concerns, the Maternal and Child Health Bureau of HHS requested that the National Research Council and the IOM convene a workshop in May 2006. The purpose of this workshop was to review trends in maternal weight; explore emerging research findings related to the complex relationship of the biological, behavioral, psychological, and social interactions that affect maternal and pregnancy weight on maternal and child health outcomes; and discuss interventions. The following specific questions were addressed by the workshop:

  • What research and databases describe the distribution of maternal weight (prior to, during, and after pregnancy) among different populations of women in the United States?

  • What research and databases inform understanding of the effects of different weight patterns (including underweight and overweight) during pregnancy on maternal and child health outcomes?

  • What research has been conducted to describe the individual, community, and health care system factors that impede or foster compliance with recommended GWG guidelines?

  • What opportunities exist for Title V maternal and child health programs to build on this knowledge to help childbearing women achieve and maintain recommended weight?

  • What future research and data collection efforts could improve the efforts of Title V programs to support women from different racial



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