Health Services

The committee found insufficient evidence to evaluate the influence of prenatal weight gain advice on actual gestational weight gain.

Studies limited by self-selection bias, recall bias, differences in time during gestation when nutrition advice was given, variation in content and frequency of advice, the pairing of advice with other food or nonfood interventions, individual and social characteristics of the provider as contrasted with those of the pregnant woman, and racial-ethnic and socioeconomic disparities in weight gain advice given to women.

Rush, 1981

Orstead et al., 1985

Olds et al., 1986

Bruce and Tchabo, 1989

Brown et al., 1992

Morris et al., 1993

Hickey, 2000

Policy

Examples include IOM guidelines, WIC programs, and policy recommendations to restrict food/beverage marketing to young children. IOM guidelines appear to influence what women believe to be appropriate weight gain during pregnancy. A national evaluation of WIC programs found a reversal of low weight gain in early pregnancy and greater total weight gain during pregnancy among women who enrolled in WIC compared with controls.

The impact of the IOM guidelines on actual gestational weight gain may be limited in part because many health professionals are providing no or inappropriate advice about weight gain during pregnancy. More research on implementation of gestational weight gain guidelines is needed.

Rush et al., 1988

Cogswell et al., 1999

ACOG, 2005

Power et al., 2006

Stotland et al., 2005

Joyce et al., 2008

Environmental

Altitude

Jensen and Moore (1997) did not find any significant difference in gestational weight gain among women residing at 3,000 to 5,000 feet, 5,000 to 7,000 feet, 7,000 to 9,000 feet, and 9,000 to 11,000 feet.

The decline in birth weight associated with increase in altitude appears to be independent of gestational weight gain.

Jensen and Moore, 1997



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