Index*

A

Acculturation, 114115

Acetoacetate, 100, 102

Adipokines, 94

Adiponectin, 94, 138139

Adolescent pregnancy

birth rate trends, 46

GWG-related risks, 121122

individual patterns of GWG, 76

infant mortality risk, 205

mean GWG ranges, 101

postpartum weight retention, 122

prepregnant BMI cutoff values, 251252

recommendations for weight gain during pregnancy, 34, 121, 260

social support as GWG determinant, 145

total GWG, 72, 155

trends, 6465

Adrenocorticotropic hormone, 94

Age at pregnancy

birth weight trends and, 57

breastfeeding rates and, 62

depression risk, 5152

gestational diabetes risk and, 5253

GWG in older women, 122123, 155

GWG patterns and trends, 3031, 34f, 124t, 126t

health risks for older women, 173

infant mortality risk, 205

prevalence of weight loss attempts during pregnancy, 146

trends, 1, 15, 46, 6465

See also Adolescent pregnancy

Age of fetal viability, 86

Agency for Healthcare Research and Quality, 5, 18, 173

Alcohol consumption, 151152

Allergy/asthma, GWG and, 226227, 230

Amniochorionic-decidual inflammation, 213, 214

Amniotic fluid changes in pregnancy, 9192, 102

Amphetamine abuse, 152

Angiotensin, 94

Anorexia nervosa, 140141

Apgar score, 225

Attention deficit hyperactivity disorder, 228, 230

*

Page numbers followed by f refer to figures and page numbers followed by t refer to tables.



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OCR for page 843
Index* A gestational diabetes risk and, 52–53 GWG in older women, 122–123, 155 Acculturation, 114–115 GWG patterns and trends, 30–31, 34f, Acetoacetate, 100, 102 124t, 126t Adipokines, 94 health risks for older women, 173 Adiponectin, 94, 138–139 infant mortality risk, 205 Adolescent pregnancy prevalence of weight loss attempts birth rate trends, 46 during pregnancy, 146 GWG-related risks, 121–122 trends, 1, 15, 46, 64–65 individual patterns of GWG, 76 See also Adolescent pregnancy infant mortality risk, 205 Age of fetal viability, 86 mean GWG ranges, 101 Agency for Healthcare Research and postpartum weight retention, 122 Quality, 5, 18, 173 prepregnant BMI cutoff values, 251–252 Alcohol consumption, 151–152 recommendations for weight gain during Allergy/asthma, GWG and, 226–227, 230 pregnancy, 3–4, 121, 260 Amniochorionic-decidual inflammation, social support as GWG determinant, 213, 214 145 Amniotic fluid changes in pregnancy, 91–92, total GWG, 72, 155 102 trends, 64–65 Amphetamine abuse, 152 Adrenocorticotropic hormone, 94 Angiotensin, 94 Age at pregnancy Anorexia nervosa, 140–141 birth weight trends and, 57 Apgar score, 225 breastfeeding rates and, 62 Attention deficit hyperactivity disorder, 228, depression risk, 51–52 230 *Page numbers followed by f refer to figures and page numbers followed by t refer to tables. 

OCR for page 843
 INDEX B hormonal system, 227–228 recommendations for research, 8, 188 Bariatric surgery, 141–142, 271 Carbohydrate metabolism, 95 Basal metabolic rate, 135–138, 139 Cardiovascular health Basal oxygen consumption, 83 long-term outcomes of GWG, 185, Bioimpedance analysis, 78 186–187 Biomarker predictors of birth outcomes, maternal changes during pregnancy, 156 92–93 Birth certificates recommendations for research, 8, 188 GWG and prepregnancy BMI data from, Centers for Disease Control and Prevention, 29–33 9, 270 recommendations for revision, 5, 33, 66 Cesarean delivery shortcomings of data from, 30 evidence for GWG linkage, 186, 187 Birth weight as GWG-related outcome, 7, 180–181 child health outcomes, 198 maternal obesity and, 54–55, 72, classification, 86, 87, 206–207 180–181 determinants, 206 risks for women of small stature, 3 fetal growth and, 206 trends, 54, 65 genetic factors in, 129–133 Childhood health gestational age and, 87, 88f allergy/asthma, 226–227 high altitude effects, 117 cancer, 227–228, 230 infants born to incarcerated mothers, long-term outcomes, 258–259 154 neurodevelopmental, 222–226, 229, 230 maternal body composition and, 102 recommendations for research, 8, maternal body water accretion and, 78 230–231 maternal plasma volume and, 78 See also Childhood obesity; Infant health maternal substance use and, 151 Childhood obesity maternal weight gain and, 73f, 198, acculturation effects, 114 208–211 associated health risks, 199–201 multiple fetus pregnancies, 88–89 developmental programming model, optimal, 86 198–199 patterns and trends, 57, 58f, 87–88 GWG linkage, 199–201, 230 prepregnancy weight and, 73f, 207 as GWG-related outcome, 7, 15, 216, rate of GWG and, 76–77 217–221, 229, 230 See also Large-for-gestational age infant weight gain patterns and, 216 infants; Low-birth weight babies; maternal glucose metabolism and, 200 Small-for-gestational age infants trends, 62–63, 64f Bone mineral, 80–83 Cholesterol, 97 Breast cancer, 186, 227–228, 230 Chorionicity, in multiple fetus pregnancies, Breastfeeding 88, 89 GWG-related outcomes, 187, 216–217 Clinical Guidelines on the Identification, trends, 62 Ealuation, and Treatment of See also Lactation Oerweight and Obesity in Adults, Bulimia nervosa, 140–141 16 Cocaine use, 152 Cognitive functioning C GWG outcomes in childhood, 225–226 neurodevelopmental outcomes of SGA Caloric intake, 48 infants, 222–225 Cancer, GWG and Contraceptive services, 9, 270, 276 birth weight and, 227 Corticosteroid-binding globulin, 93 evidence for linkage, 186, 227–228, 230

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 INDEX Cortisol levels, 93–94 intake patterns and trends, 47–49, 65 Cost-effectiveness of strategies for achieving interpersonal support during pregnancy GWG recommendations, 10, 11, 277 and, 120 Crohn’s disease, 139–140 media influence, 113–114 Cutoff points, BMI, 5, 28–29, 66, 250–251, metabolic changes during pregnancy 256, 259 and, 94–95 Cytokines, 85, 95, 98, 138–139 nutrient intake as GWG determinant, 147–148 preconception counseling, 9, 270, 276 D preterm birth risk, 214 prevalence of weight loss attempts Dehydroepiandrosterone sulfate, 94 during pregnancy, 146 Department of Health and Human Services, protein supplementation, 207 recommendations for, 5, 10, 65–66, psychological stress and, 144–145 156, 277–278 research needs, 65, 102–103, 155, 156, Depression, 51–52, 143–144, 185, 186 271 Developmental programming, 133–134, significance of, in GWG, 154 197–199 for successful pregnancy and lactation, Diabetes, gestational 49 childhood developmental outcomes and, Dietitians, 10, 274 200 evidence for GWG linkage, 175, 176–177, 186 E fetal growth and, 87, 91 metabolic changes during pregnancy, Eating disorders, 140–141 95–96, 176 Eclampsia. See Preeclampsia and placental development and, 85–86 hypertensive disorders risk, 176 Ecological perspective, 111, 275–276 trends, 1, 15, 52–53, 65, 176 Edema, 78 Diet and nutrition Educational attainment access to healthy foods, 118–119, 275 breastfeeding rates and, 62 basal metabolic rate and, 137 GWG and, 125, 126t caloric intake as GWG determinant, physical activity patterns, 50–51 146–147, 258 trends, 46 challenges to achieving recommendations Educational interventions for, 264 to achieve GWG recommendations, 9, clinical implementation of GWG 271, 277 guidelines, 3, 274 effectiveness of GWG advice, 115–116, cultural influences, 114–115 267 dieting practices, 49, 65 media campaigns, 114 effectiveness of GWG advice, 115–116, See also Preconception counseling 267 Endocrine function, 93–94, 97 fasting effects on maternal metabolism, Epidemiological field model of health 99–100, 102 behaviors and outcomes, 112 food insecurity, 49, 127, 156 Epigenetic influences glycemic load as GWG determinant, 148 on GWG, 134, 188 goals of pregnancy counseling, 11, 276 on postnatal outcomes, 197 GWG in older women, 123 Estrogen, 95, 98, 227–228 information resources for pregnant Exercise. See Physical activity women, 274 Extracellular fluid, 78

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 INDEX F G Family-level determinants of GWG, 119, Gender differences, fetal growth, 87, 91 120 Genetic factors in GWG, 128–133, 155 Fat accretion during pregnancy Gestational weight gain (GWG) clinical significance, 102 in adolescents, 121–122 depression and, 144 amniotic fluid changes and, 91–92, 102 fetal, 89, 91 among vulnerable populations, 153–154, maternal, 79–83, 90 155 physical activity and, 150 attitudes toward weight gain and, postpartum retention, 80, 182 145–146 recommendations for research, 231 birth weight and, 198 Fat-free mass accretion during pregnancy childhood obesity and, 199–201 fetal, 90 clinical significance, 243 maternal, 78–79, 80–83, 90 conceptual models for evaluating Federal Human Nutrition Research and determinants of, 111–112 Information Management System conceptual models for evaluating Database, 156 outcomes of, 174–175, 196–197 Fetal development cultural influences, 114–115 age of viability, 86 data needs to assess trends, 31t, 66 body composition, 89–91 data sources, 29, 32t, 173–174 determinants, 86 determinants, 21, 111, 112, 113f, gender differences, 87 154–155 growth patterns, 86–88 developmental programming as factor GWG linkages to fetal growth, 206–212, in, 133–134 230, 257–258 dietary intake and, 146–148 high altitude effects, 87, 91, 117 distribution among components of, 77 maternal characteristics associated with, effectiveness of health services 211–212 counseling, 115–116 maternal glucose metabolism and, environmental determinants, 117–118 199–200 epigenetic influences, 134 maternal health and, 87 fetal body composition and, 90, 91 measurement and classification, fetal components, 86–91 86, 87 genetic factors, 128–133, 155 in multiple fetus pregnancy, 88–89 hormonal factors, 98, 138 neonatal body composition, 215–216, individual patterns of, 75–77, 255–256 230 infant health outcomes related to, 7, 8, neurophysiology, 222–226 175, 202–215, 222–229 placental physiology, 97–99 interpersonal determinants, 119–120 placental weight and, 83–84 labor and delivery complications racial/ethnic differences, 87, 206–207 associated with, 179–181 research challenges, 86 lifestyle factors in, 46–51 risks in adolescent pregnancy, 121–122 linkage with maternal health risks, stillbirth risk, 203, 229 175–179 toxin exposure, 117–118 long-term child health outcomes and, water content, 85 215–221, 222–225, 230 See also Birth weight; Preterm birth maternal age and, 124t Follicle-stimulating hormone, 94 maternal body composition and, 78–83 Food. See Diet and nutrition maternal components of, 77–78 Free fatty acid, 100 maternal determinants, 120–121

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 INDEX maternal health outcomes related to, 5– placental transport function, 97 7, 8, 15, 52, 75, 173, 174, 186–187, pregnancy course, 95 242 recommendations for research, 8, 188 mean ranges, 101, 264 See also Insulin and insulin sensitivity media influence, 113–114 Growth hormone, 94 metabolic changes and, 96–97, 135–138 GSG. See Gestational weight gain monitoring individual pregnancy, 256, Guidelines for weight gain during pregnancy 271–272 applicability, 2, 242 in multiple fetus pregnancies, 101–102 challenges to achieving recommendations neighborhood/community determinants, for, 263–264, 270 118–119, 275–276 clinical implementation, 3, 255–256 new recommendations, 2–3 conceptual approach for review and in older women, 122–123 development of, 4–5, 6f, 14, 18–19, outcomes data, 173–174 20f, 111, 241–242, 249–251, 270 parity and, 253 data sources in development of, 2, 5–7, physical activity and, 149–151 18, 21, 25, 29, 32t, 249–250, 258, placental changes in, 83–86, 98 310–313t placental metabolism in, 71 demographic and clinical trends policy factors, 116–117 indicating review and revision, 1, population patterns and trends, 1, 21, 14–16 25, 29–40, 101 effectiveness of interventions to promote, postpartum weight retention and, 41, 267–269 42, 44, 45, 187 evolution of, 13–14 pre-existing morbidities and, 139–143, 173 goals for review and revision, 1–2, prepregnancy BMI and, 31–33, 35–36, 16–18 37–39f, 72, 75, 102, 135, 136t, implementation problems, 16, 267 246–247, 265t, 266f implementation rationale, 11, 276–277 psychological factors in, 51–52, new recommendations, 2–3, 254–255, 143–146 256–259 research needs, 5, 7–8, 65–66 previous approaches for developing, societal/institutional determinants, 243–247, 248t 112–113 previous strategies for implementation, sociodemographic differences, 121–127 266–267 substance abuse and, 151–152 promoting public awareness of, 9, 271 total weight gain, 72–75, 101 recommendations for special in unintended pregnancies, 152–153 populations, 3–4, 251–254, 260 See also Guidelines for weight gain research goals, 1–2 during pregnancy; Monitoring research needs for future improvements, individual weight changes during 8–9, 11, 277 pregnancy; Weight loss or low weight single target approach, 243 gain during pregnancy strategies for achieving Glomerular filtration rate, 93 recommendations, 9–10, 11, 260, Glucocorticoid levels, 133 270–276 Glucokinase, 130 trade-offs between maternal and child Glucose metabolism health in, 242, 243–245, 258 fat mass accretion during pregnancy and, 83 H fetal development risks, 199–200 gestational diabetes risk, 176 Health care providers GWG and, 176 attitudes toward GWG ketonuria/ketonemia risk, 100, 101 recommendations, 155–156

OCR for page 843
 INDEX charts for monitoring weight changes, conceptual approach to review and 10, 272–274 development of GWG guidelines, 21, effectiveness of GWG advice, 115–116, 241–242 267 developmental plasticity, 197 effectiveness of interventions to promote developmental programming model of healthy GWG, 267–269 GWG effects, 197–199 recommendations for data collection, 66, findings of previous GWG studies, 256 243–247 strategies for achieving GWG GWG-related outcomes, 7, 8, 15, recommendations, 9–10, 266–267, 202–203, 222–230 271–276, 277 model of GWG linkage, 196–197 See also Preconception counseling mortality, 56, 57, 65, 204–206 Health field model of health behaviors and neonatal body composition, 215–216, 230 outcomes, 111–112 neurodevelopment, 222–226 Healthy People 00, 49, 50 potential mechanisms of GWG linkage, Height, maternal, 257 197 Hepatocyte nuclear factor 4 alpha, preterm birth, 212–215, 229, 230 131–132 recommendations for research, 8, 188, Hepatocyte nuclear factor 1 beta, 131 230–231 High altitude effects, 87, 91, 117 reduced maternal food intake and, 146 Hormonal system research challenges, 195–196 breast cancer and, 227–228 research needs, 259–260 changes in pregnancy, 93–94, 95 weight gain, 216 in GWG, 138 weight loss or low GWG during placental development and, 85, 98–99 pregnancy and, 8, 204–205, 212, research needs, 103 229 Human placental lactogen, 98 See also Childhood health; Childhood β-Hydroxybutyrate, 100, 101, 102 obesity; Fetal development; Large- beta-Hydroxybutyrate, 100, 101, 176 for-gestational age infants; Low-birth Hyperemesis gravidarum, 140, 179 weight babies; Small-for-gestational Hypertension. See Preeclampsia and age infants hypertensive disorders Inflammatory bowel disease, 139–140 Hypothalamic-pituitary-adrenal response Inflammatory response in GWG, 133 metabolic changes during pregnancy, preterm birth pathogenesis, 213, 214 95–96, 103 nutrient utilization and, 102 placental development and, 85 I placental regulation, 71 preterm birth pathogenesis, 214 Immune system syncytiotrophoblast microparticles in, 99 GWG–asthma linkage, 226–227 Influence of Pregnancy Weight on Maternal preterm birth pathogenesis, 214 and Child Health, 17 Individualized attention to women during Insulin and insulin sensitivity pregnancy, 10, 256, 271–275 adiponectin levels and, 94, 139 Induced labor, 179–180 fat mass accretion during pregnancy Infant Feeding Practices Study, 42–44, 45, and, 83 174–175, 310–311t in fetal development, 89 Infant health fetal development risks, 199–200 Apgar score, 225 GWG and, 96–97, 138 birth defect risk, 204 hypothalamic-pituitary-adrenal birth weight as risk factor, 198 hyperactivity and, 133

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 INDEX ketonuria/ketonemia risk, 100 Low-birth weight babies leptin and, 139 causes, 57 long-term outcomes of GWG, 185 GWG and, 208–209 metabolic changes during pregnancy, mortality risk, 57 95–96 trends, 57, 65 patterns of, 96 See also Birth weight placental regulation, 71, 85, 98 Low-income women risk of gestational diabetes, 176, 199 food insecurity, 49, 127 Intelligence quotient, 222, 223, 224, 226 GWG patterns and trends, 36–37 Intracellular water, 78 need for individualized attention during Intrauterine growth restriction, 207 pregnancy, 10, 276 Iron-deficiency anemia, 214 recommendations for research on guideline implementation, 10, 277–278 K strategies for implementing GWG guidelines, 276 Ketonuria/ketonemia, 8, 100–101, 102, Lupus erythematosus, 139–140 176, 257 Luteinizing hormone, 94 L M Labor and delivery Macrosomia, 57, 200, 207, 209 GWG linkage with complications of, Marital status, 119–120, 155 179–181 Maternal health induction of labor, 179–180 conceptual approach to review and length of labor, 180 development of GWG guidelines, 21, LGA babies, 206 241–242 See also Cesarean delivery conceptual framework for studying Lactation GWG outcomes, 174–175 dietary intake for, 49 fat accretion during pregnancy, 79–83 GWG and, 181–182 fetal body composition and, 91 Large-for-gestational age infants fetal growth and, 87 causes, 59, 65 findings of previous GWG studies, definition, 7, 86, 206 243–247 delivery complications, 206 GWG among obese women and, 72 genetic risk, 129, 130 GWG-related risks, 5–7, 8, 15, 52, 75, as GWG-related outcome, 7, 209, 173, 186–187 228–230, 257–258 long-term outcomes, 259 GWG-related risk among obese women, metabolic changes during pregnancy, 72 94–98 placental weight and, 84 mortality, 55–56, 65, 181, 187 trends, 59, 60t, 65 physiologic changes during pregnancy, Leptin, 98, 138–139 92–94 Leukemia, 227 postpartum risks, 175 LGA. See Large-for-gestational age infants pre-existing morbidities related to GWG, Life-course perspective, 112, 196–197 139–143 Lipid metabolism prenatal risks, 175 changes in pregnancy, 95 protein accretion during pregnancy, placental regulation, 98 78–79 placental transport function, 97 recommendations for research, 188

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0 INDEX research needs, 259–260 birth weight trends and, 57 risks for older women, 122–123 fetal development patterns, 88–89 total body water accretion during GWG patterns, 76–77, 101–102, 143 pregnancy, 78 placental weight in, 84 See also Cesarean delivery; Diabetes, recommendations for research, 260 gestational; Postpartum health recommendations for weight gain outcomes; Preeclampsia and during, 4, 252, 260 hypertensive disorders total GWG patterns, 73–75 Maternal Nutrition and the Course of Pregnancy, 13, 243 N Media influence of health behavior, 113–114 National Center for Clinical Excellence, 243 Mental health and psychosocial functioning National Heart, Lung, and Blood Institute, evidence for GWG linkage to outcomes 16, 29 in, 175, 178–179, 187 National Institutes of Health, GWG determinants, 143–146, 154 recommendations for, 5, 7–9, long-term outcomes of GWG, 186 102–103, 155, 188, 230–231, 260 patterns and trends, 51–52 Natural disasters, 118 recommendations for research, 8, 156, Neurodevelopment, 222–226, 229, 230 188 Nitrogen metabolism, 95 social support as GWG factor, 145 Nutrition During Lactation, 15 weight gain attitudes as GWG Nutrition During Pregnancy, 13–14, 15, determinant, 145–146 195, 241, 264 See also Depression; Stress Nutrition During Pregnancy and Lactation: Metabolic changes during pregnancy An Implementation Guide, 9–10, 14, GWG determinants, 135–138 15, 266–267, 270–271 ketonuria/ketonemia, 100–101 Nutrition Serices in Perinatal Care, 266, maternal, 94–97 271 placental–maternal interaction, 99–100 research needs, 103 weight loss and, 99–100 O Metabolic syndrome, 133–134 Methamphetamine use, 152 Obesity Migrant workers, 153 postpartum weight retention and Military personnel, 153 subsequent risk for, 182, 184, 187 Monitoring individual weight changes See Overweight and obese women during pregnancy Obesogenic environment, 112 BMI measurement, 66 Obstetrical procedures challenges to achieving birth weight trends and, 57, 65 recommendations, 264 Oligohydramnios, 92 charts for, 10, 272–274 Overweight and obese women rationale, 264–266 adolescent pregnancy as risk factor, 122 recommendations for health care bariatric surgery implications for providers, 66, 255–256 pregnancy, 141–142 Mortality body composition changes in pregnancy, causal classification, 181 80–81, 83 infant, 56, 57, 65, 202f, 204–206 body composition of neonates of, 215 maternal, 55–56, 65, 181, 187 cesarean delivery risk, 54–55 research needs, 56, 188 classification, 5, 29 Multiple fetus pregnancy dieting practices, 49 birth weight outcomes of GWG, 76–77 epidemiology, 15

OCR for page 843
 INDEX fasting effects during pregnancy, 99–100 data sources, 51 fetal growth outcomes, 207, 208 goals of pregnancy counseling, 11, 276 findings of previous GWG studies, 246 as GWG determinant, 149–151, 154 food insecurity and, 127 information resources for pregnant GWG patterns, 35–36, 72–73, 76, 77, women, 274–275 101 media influence, 114 health risks in pregnancy, 72, 173 neighborhood determinants of GWG, hypertensive disorder risk in pregnancy, 119 177 patterns and trends among women, infant mortality risk, 204–205 49–51, 65 mortality risk, 56 preconception counseling, 276 outcomes of multiple fetus pregnancies, pregnancy and birth outcomes, 148–149 77 recommended levels, 49, 148, 275 placental development in, 85 research needs, 155, 275 postpartum weight retention, 44, 45 sociodemographic differences, 50–51 preconception bariatric surgery, 142, Physical Activity Guidelines Advisory 271 Committee, 275 rate of GWG, 255 Placenta recommendations for data collection, 66 composition, 85–86 recommendations for GWG, 3, 7, fetal growth and, 97, 102 250–251, 253, 259 function in pregnancy, 71, 97 recommendations for research, 7, 102 functional changes in pregnancy, 85 recommended weight gain chart, 274f growth during pregnancy, 84 research needs, 56 hormone production, 98–99, 103 risks for older pregnant women, insufficiency, 84 122–123 lipid content, 86 severity prevalence, 27 maternal metabolism and, 97–98 trends, 1, 15, 25–26, 63–64 normal development, 84 weight loss during pregnancy, 7–8 structural changes in pregnancy, 84–85 See also Childhood obesity transport function, 97 Oxygen consumption, 93 weight changes during pregnancy, 83–84 Plasma volume, 78, 93, 94, 102 Policy formulation, 116–117 P Polyhydramnios, 92 Postpartum health outcomes Parenchyma, 84–85 depression, 185 Parity, 253 GWG-associated risks, 175, 181–182, Pattern(s) of weight gain, 255–256 185 child health outcomes, 231 long-term risks, 185–187 new recommendations, 2t, 255 obesity risk, 182, 184, 187 normal rate, 255 See also Postpartum weight retention recommendations for research, 231 Postpartum weight retention singleton pregnancies, 75–76 body composition changes, 81–83 statistical curve, 75 counseling goals, 11, 274, 276 twin pregnancies, 76–77 data sources, 41, 42, 258–259 Pediatric Nutrition Surveillance System, definition, 182 310–311t fat accretion patterns, 80, 182 Physical activity food insecurity during pregnancy and, challenges to achieving recommendations 127 for, 264 GWG and, 41, 42, 44, 45, 102, clinical implementation of GWG 182–184, 187, 246–247, 258 guidelines, 3, 274–275

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 INDEX long-term outcomes, 258 hypertensive disorder risk, 177 measurement, 40–41 individual patterns of GWG and, obesity risk, 182, 184, 187 75–76 patterns and trends, 41–46 maternal health outcomes and, 187 psychological stress as risk factor, 144 maternal height and, 257 recommendations for research, 5, 7, neonatal health outcomes, 202 65–66 obesity prevalence, 28 risk for adolescent mothers, 122 physical activity as GWG determinant Preconception counseling and, 150–151 effectiveness, 271 placental development and, 85 effectiveness of GWG advice, 115–116 population distribution patterns, 26–27t, goals, 11, 270–271, 276 30t recommendations for, 9, 187, 277 postpartum weight retention and, scope, 9, 270, 271 246–247 Preeclampsia and hypertensive disorders preterm birth risk, 213 evidence for GWG linkage, 175, rate of GWG, 255 177–178, 186, 187, 242 social support as GWG determinant and, GWG-related risk among obese women, 145 72 stillbirth risk, 203 recommendations for research, 8, 188 strategies for achieving risk, 177 recommendations, 270–271 trends among pregnant women, 1, trends, 1, 25–28, 263 53–54, 65 women of short stature, Pregnancy Nutrition Surveillance System, recommendations for, 3 36–37, 40, 41, 45–46, 312–313t Preterm birth Pregnancy Risk Assessment Monitoring asthma risk, 226 System, 33–36, 40, 312–313t causes, 60 Prepregnancy BMI frequency, 87 adolescent cutoff values, 251–252 as GWG-related outcome, 7, 212–215, adolescents, recommendations for, 3–4 229, 230 attitudes toward weight gain as GWG long-term neurodevelopmental determinant, 146 outcomes, 224–225 birth defect risk, 204 morbidity risks associated with, 212 birth weight outcomes, 73f, 74, 207, pathophysiology, 213–214 210–211 prepregnancy BMI and, 213 body composition changes in pregnancy racial/ethnic differences, 60, 61f and, 80–83 trends, 60, 61f, 65 challenges to achieving recommendations Prison population, 154 for, 263–264 Progesterone, 95, 98 classification, 5, 28–29, 66, 250–251 Prolactin, 94 clinical significance, 7, 13, 259 Promoting Health: Interention Strategies cutoff points, 2–3, 5, 250–251, 256, 259 from Social and Behaioral Sciences, data sources, 29 275 dietary intake as GWG determinant and, Protein accretion during pregnancy 147 fetal, 90 fetal body composition and, 91 maternal, 78–79, 83 GWG and, 31–33, 35–36, 37–39f, 72, Protein metabolism, 95 75, 102, 135, 136t, 265t, 266f Protein supplements, 207 GWG recommendations as proportion Public awareness of GWG guidelines, 9, of, 243 271

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 INDEX R infant and child health outcomes, GWG- related, 8, 230–231, 259–260 Racial/ethnic subgroups longer term outcomes, 259 acculturation effects on dietary practices, low GWG or weight loss during 114–115 pregnancy, 7–8 birth weight patterns, 57, 58f maternal characteristics associated with BMI distribution patterns and trends, GWG, 8, 188 26–27t maternal health outcomes of GWG, 188, breastfeeding rates, 62 259–260 childhood obesity, 63 maternal mortality, 56, 188 depression risk, 52f, 143 obesity during pregnancy, 7, 102 fetal development, 87 physical activity behaviors and fetal growth measurement, 206–207 outcomes, 156, 275 GWG patterns and trends, 30–31, 34f, racial/ethnic subgroups, 4 36–37, 40f, 123–125, 126t, 253 for review of GWG guidelines, 16–17 individual patterns of GWG, 76 strategies to achieve GWG infant mortality, 56, 57f recommendations, 10, 277–278 large-for-gestational age births, 59, 60t surveillance of GWG and postpartum maternal mortality patterns, 55 weight retention, 5, 65–66 need for individualized attention during weight loss or low GWG, 103 pregnancy, 10, 276 Respiratory function, maternal, 93 obesity risk, 26, 27, 28, 64 physical activity patterns, 50 postpartum weight retention patterns S and trends, 41, 42t, 43f, 45–46 Screening preterm births, 60, 61f depression, 51–52 prevalence of weight loss attempts See also Monitoring individual during pregnancy, 146 weight changes during pregnancy; recommendations for research on Surveillance of GWG and postpartum guideline implementation, 10, weight retention 277–278 Short stature, women of recommendations for weight gain during recommendations for weight gain during pregnancy, 4, 253, 260 pregnancy, 3, 251, 260 research needs, 4, 16–17, 156, 188, 260 risk of negative pregnancy outcomes, 3, small-for-gestational age births, 59 251 sociodemographic trends, 1, 46, 64 Small-for-gestational age infants weight-related predictors and outcomes definition, 7, 59, 86, 206 and, 65 developmental programming effects, 198 Reactive oxygen species, 214 genetic risk, 129, 130 Renal function, 93 as GWG-related outcome, 7, 209, Research needs 210–211, 228–230, 257–258 birth data, 5, 66 GWG-related risk among obese women, determinants of GWG, 155–156, 72 275–276 health complications associated with, dietary practices, 65, 102–103, 156, 271 206 for future guideline development, 8–9, long-term neurodevelopment, 222–225 277 placental weight and, 84 health care provider attitudes and trends, 59 beliefs, 155–156 Smoking, 46, 91, 151, 253–254 hormonal factor in maternal metabolism Snack foods and soft drinks, 48 regulation, 103

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 INDEX Social marketing, 114, 276 Title V programs, 16–17 Sociocultural context of health behaviors Total body nitrogen, 82–83 and outcomes Total body potassium, 78, 79, 80–83, 90 assessment for obstacles to healthy Total body water accretion, 78, 80–83, 90, GWG, 272–274 93 conceptual models, 112 Total energy expenditure, 135–138, family and partner factors, 119–120 150–151 GWG determinants, 112–117 Total GWG neighborhood/community factors, singleton pregnancies, 72–73 118–119, 275–276 triplet and quadruplet pregnancies, 75 research needs, 155, 275–276 twin pregnancies, 73–75 social support factors, 145 Toxin exposure, 117–118 Sociodemographic trends, 1, 15, 46, 47t, Twins. See Multiple fetus pregnancy 63–65 Socioeconomic status, 125, 127, 188. See U also Low-income women Sodium levels, 93 Unintended pregnancy, 152–153 Special populations Unmarried mothers, 46, 64–65 GWG among, 153–154, 155 incarcerated women, 154 migrant workers, 153 V military personnel, 153 See also Adolescent pregnancy; Low- Violence exposure, 119, 155 income women; Multiple fetus pregnancy; Racial/ethnic subgroups; W Short stature, women of Special Supplemental Food Program for Weight loss or low weight gain during Women, Infants, and Children, 117 pregnancy Stillbirth, 203, 229 among obese women, 72–73 Stress birth defect risk, 204 developmental programming, 133 childhood diabetes risk, 201 GWG and, 144–145 dieting practices among pregnant natural and man-made disasters, 118 women, 49, 65 physiology, 133 fasting metabolism, 99–100, 102 Stretch marks, 179 fetal growth and, 207, 208, 210, 229 Substance use, 151–152 health risks for obese women, 72 Surveillance of GWG and postpartum infant mortality risk, 204–205 weight retention maternal body composition outcomes, individualized attention, 10 103 recommendations for research, 5, 65–66 preterm birth as outcome of, 212, 229 Syncytiotrophoblast microparticles, 99 prevalence of weight loss attempts, 146 psychological stress and, 145 T recommendations for research, 7–8, 103 stillbirth risk, 203 Teenage mothers. See Adolescent pregnancy World Health Organization, 2–3, 5, 29, 66, Thyroid changes in pregnancy, 94 250–251, 259 Thyroxine-binding globulin, 94