ing all classes of obesity), age, racial/ethnic group, and socioeconomic status.

Action Recommendation 2-2: The committee recommends that all states adopt the revised version of the birth certificate, which includes fields for maternal prepregnancy weight, height, weight at delivery, and gestational age at the last measured weight. In addition, all states should strive for 100 percent completion of these fields on birth certificates and collaborate to share data, thereby allowing a complete national picture as well as regional snapshots.

Supporting Actions

  1. At the first prenatal visit, health care providers should record weight at last menstrual period and maternal height without shoes. Gestational weight gain should be based on measured weights (in light clothing and no shoes) abstracted from prenatal records. Gestational age at the last recorded weight should be documented, preferably through an early ultrasound, to properly evaluate adequacy of weight gain. To aid in data analysis, all data should be collected in a continuous form rather than categorically.

  2. As part of maternal weight surveillance, health care providers should document the prevalence of obesity grades I, II, and II rather than categorize women into one obesity group (BMI > 30 kg/m2).

Areas for Additional Investigation

The committee identified the following areas for further investigation to support its research recommendations:

  • The research community should conduct future monitoring of GWG.

  • Federal agencies should standardize the use of the WHO BMI cutoff points in all data collection relevant to monitoring weight gain in pregnancy.

REFERENCES

American Psychiatric Association. 1994. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.

Bish C. L., H. M. Blanck, M. K. Serdula, M. Marcus, H. W. Kohl, 3rd and L. K. Khan. 2005. Diet and physical activity behaviors among Americans trying to lose weight: 2000 Behavioral Risk Factor Surveillance System. Obesity Research 13(3): 596-607.



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