tational weight gain and includes the promotion of appropriate weight before, during, and after pregnancy. In addition, HRSA considers preconceptional and interconceptional counseling and full implementation of the 2009 pregnancy weight gain guidelines to be important changes in the care that is provided to women. Finally, HRSA is committed to continued research on effective interventions to promote healthy weight in women before and after pregnancy and to help women achieve weight gain during pregnancy that is within the recommended ranges.

SUZANNE PHELAN, CALIFORNIA POLYTECHNIC STATE UNIVERSITY

In considering ways to disseminate the IOM pregnancy weight gain guidelines, Phelan said, workshop participants face three large questions: One, do we know how to help women gain the recommended amounts of weight in pregnancy? Two, are we ready to translate the knowledge into action? Three, what should the future look like?

Results from the Fit for Delivery study, a randomized controlled trial to prevent excessive weight gain in pregnant women, provide one answer to the first question. The study recruited 200 normal weight and 200 overweight and obese pregnant women, each of whom was assigned to either standard care or standard care plus a lifestyle modification treatment program. The intervention, which was low intensity, focused on gestational weight gain, healthy eating, moderate physical activity, behavioral strategies, and motivation. Motivation was addressed in one face-to-face visit at the research center at the beginning of the study combined with weekly mailing of printed cards that challenged the women to engage in a different health behavior each week. All of the women received three brief phone-based counseling sessions and additional phone intervention if they were gaining too much or not enough weight. The women also received weight gain graphs after each of their regularly scheduled prenatal visits so that they could see how their weight gain compared to the guidelines. All the data were collected before the 2009 IOM revised guidelines were published, so results were based on the 1990 guidelines. However, after the appearance of the revised guidelines, the data were re-analyzed according to those guidelines, and the results were the same.

The study’s results showed that the intervention appeared to prevent excessive weight gain in the normal-weight women but not in the overweight and obese women. Fifty-two percent of the normal-weight women who received standard care exceeded the weight gain recommended in



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