married mothers and a decrease in the proportion of teenaged mothers; and

  • low (< 16 pound) and high (> 40 pound) GWG has become more common.

  1. American women of childbearing age are far from meeting national goals for dietary intake and physical activity, yet there is a dearth of nationally representative data on dietary intake, dieting practices and food insecurity among women of childbearing age in general and among pregnant women in particular.

  2. About half of reproductive-aged American women are trying to lose weight, and another one-third of pregnant women may be attempting to maintain their weight. The prevalence of attempted weight loss during pregnancy doubled in the past 20 years.

  3. Rates of preterm birth, GDM, and hypertensive disorders of pregnancy are increasing. The rise in cesarean births and the decline in LGA births appear to result from medical practice patterns and social factors.

  4. In the past 10 years, improvements that were observed during the twentieth century in maternal mortality and poor infant outcomes (mortality and low birth weight) have declined or ceased.

  5. There are racial and ethnic disparities in nearly all weight-related predictors and outcomes reviewed.

  6. Currently available data sources are inadequate for studying national trends in GWG. Even after the IOM (1990) report called for more sophisticated analyses, major gaps in GWG surveillance remain; specifically, data on prepregnancy weight and height, reliance on self-reported weight gain, and nationally representative sources are lacking.

  7. Gestational weight gain in excess of the recommended range for BMI is associated with significant postpartum weight retention.

  8. Major gaps in surveillance of postpartum weight exist. Notably, most national studies lack data on postpartum weight and/or the variables needed for its proper interpretation (namely, prepregnancy height and weight, GWG, dietary intake, physical activity, and breastfeeding status).

Action Recommendations

Action Recommendation 2-1: The committee recommends that the Department of Health and Human Services conduct routine surveillance of GWG and postpartum weight retention on a nationally representative sample of women and report the results by prepregnancy BMI (includ-



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