WIC program, using the IOM (1990) cutoff value of 37 weeks' gestation for the previous occurrence.

History of Postterm Delivery

Prevalence of and Factors Associated with Postterm Delivery

Postterm delivery (typically defined as pregnancy extending beyond 42 weeks from the onset of the last menstruation) is a fairly frequent occurrence. The prevalence of history of postterm delivery is difficult to ascertain because of uncertainties that typically surround estimation of gestational age. The prevalence of history of postterm delivery among WIC participants was not available to the committee.

History of Postterm Delivery as an Indicator of Nutrition and Health Risk

History of postterm delivery is associated with increased risks for the fetus, such as hypoxia, meconium aspiration, and macrosomia (ACOG, 1989).

History of Postterm Delivery as an Indicator of Nutrition and Health Benefit

The committee finds no evidence of benefit to support retaining history of postterm delivery as a nutrition risk criterion in the WIC program.

Recommendation for History of Postterm Delivery

The risk of history of postterm delivery is not well documented in women, and it is difficult to identify this because of uncertainties that typically surround estimation of gestation age. There is no theoretical or empirical basis for benefit from participation in the WIC program. Therefore, the committee recommends discontinuation of use of history of postterm delivery as a nutrition risk criterion for women by state WIC programs.

History of Low Birth Weight

Low birth weight (see section ''Low Birth Weight" in Chapter 4) occurs because of either preterm birth or fetal growth restriction. As discussed above, women who have delivered early are at increased risk of repeat preterm birth in a subsequent pregnancy, and those who have delivered an infant who is small



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