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Weight Gain During Pregnancy: Reexaming the Guidelines
performance, postpartum weight retention, cardiovascular disease, metabolic processes including glucose and insulin-related issues, and risk of other chronic diseases; for infants and children, in addition to low birth weight, consider early developmental impacts and obesity-related consequences (e.g., mental health, diabetes).
Recommend revisions to the existing guidelines, where necessary, including the need for specific pregnancy weight guidelines for underweight, normal weight, and overweight and obese women and adolescents and women carrying twins or higher-order multiples.
Consider a range of approaches to promote appropriate weight gain, including:
individual (behavior), psychosocial, community, health care, and health systems;
timing and components of interventions; and
ways to enhance awareness and adoption of the guidelines, including interdisciplinary approaches, consumer education to men and women, strategies to assist practitioners to use the guidelines, and public health strategies.
Identify gaps in knowledge and recommend research priorities.
Approach to the Task
The committee approached its task by gathering information from existing scientific literature, including a systematic review of the literature by the Agency for Healthcare Research and Quality (AHRQ) (Viswanathan et al., 2008) as well as additional studies not included in the AHRQ review (see Appendix E for literature reviewed). The committee also gathered information from presentations by recognized experts in three workshops (see Chapter 9), consulted with additional experts in relevant fields, and commissioned four new data analyses. Contributions made to the committee by consultants are noted throughout the report. The information-gathering activities laid the groundwork for the committee’s work of deliberating on issues relevant to the task and formulating a strategy to address the scope of work. This task was not regarded by the committee as a formal systematic, evidence-based review, as the full range of literature did not lend itself to this type of task. Rather, because of the wide-ranging and large literature on this subject, the committee relied on its collective expertise to determine how much weight to give to all of the sources of information at its disposal.
The committee worked from the perspective that pregnancy-related weight begins before conception and continues through the first year postpartum and affects both the mother and her child. In consideration of