outcomes of mothers and children that occur after the neonatal period.

  1. There is insufficient evidence to continue to support a modification of GWG guidelines for African American women, women of short stature, or adolescents younger than 16 years of age.

  2. There is insufficient data with which to establish how much more weight women carrying multiple fetuses should gain beyond that recommended for women carrying singleton fetuses.

  3. The committee reaffirms the clinical recommendations in IOM (1990) for implementation of these guidelines.

  4. There is insufficient evidence to reject the possibility that racial/ethnic group modifies the association between GWG and important maternal and child health outcomes.

Recommendation for Action

Action Recommendation 7-1: The committee recommends that relevant federal agencies, private voluntary organizations, and medical and public health organizations should adopt these new guidelines for GWG and publicize them to their members and also to women of childbearing age.

Recommendation for Research

Research Recommendation 7-1: To permit the development of improved recommendations for GWG in the future, the committee recommends that the National Institutes of Health and other relevant agencies should provide support to researchers to (a) conduct studies to assess utilities (values) associated with short- and long-term health outcomes associated with GWG for both mother and child and (b) include these values in studies that employ decision analytic frameworks to estimate optimal GWG according to category of maternal prepregnancy BMI and other subgroups.

Additional Recommendation for Research

Additional Research Recommendation 7-1: The committee recommends that the National Institutes of Health and other relevant agencies should provide support to researchers to conduct studies among women carrying multiple fetuses that link GWG to relevant health outcomes among both mothers and their infants.



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