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Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines; Rasmussen KM, Yaktine AL, editors. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington (DC): National Academies Press (US); 2009.

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Weight Gain During Pregnancy: Reexamining the Guidelines.

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Preface

In the last century, many answers have been given by health professionals to the question “how much weight should I gain while I am pregnant?” In the early 1900s, the answer was often only 15–20 pounds. Between 1970 and 1990, the guideline for weight gain during pregnancy was higher, 20–25 pounds, and in 1990, with the publication of Nutrition During Pregnancy, it went higher still for some groups of women. This most recent guideline reflected new knowledge about the importance of maternal body fatness before conception, as measured by body mass index, for the outcome of pregnancy. It had become clear that heavier women could gain less weight and still deliver an infant of good size. Since that time, the obesity epidemic has not spared women of reproductive age. In our population today, more women of reproductive age are severely obese (obesity class III; 8 percent) than are underweight (3 percent), and their short- and long-term health has become a concern in addition to the size of the infant at birth. Clearly the time had come to reexamine the guidelines for weight gain during pregnancy.

To prepare for this possibility, the National Research Council and the Institute of Medicine held a workshop in 2006 to evaluate the availability of data that could be used to reexamine the current guidelines. Based on the outcome of this workshop, numerous federal agencies (U.S. Department of Health and Human Services Health Resources and Services Administration; Centers for Disease Control and Prevention Division of Nutrition and Physical Activity and Obesity; National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health and Human Development; National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases; U.S. Department of Health and Human Services Office on Women’s Health; U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion; March of Dimes; with additional support from U.S. Department of Health and Human Services Office of Minority Health and the National Minority AIDS Council) agreed to sponsor the work of this committee.

The committee was asked to review the determinants and a wide range of short- and long-term consequences of variation in weight gain during pregnancy for both the mother and her infant. Based on the outcome of this review, the committee was asked to recommend revisions to the current guidelines if this was deemed to be necessary. In addition, the committee was asked to consider the approaches that might be necessary to promote appropriate weight gain and to identify gaps in knowledge and make recommendations about priorities for future research.

Although many studies relevant to the committee’s charge have been published since 1990 and the Agency for Healthcare Research and Quality (AHRQ) completed its report Outcomes of Maternal Weight Gain while the committee was gathering data, many gaps in knowledge remained. To address this problem, the committee held a public session with project sponsors, and two workshops. We are grateful to those who participated in these sessions for sharing their experience and wisdom. We are also grateful to a number of individuals who supplied data to the committee: Raul Artal, Amy Branum, Marie Cedergren, Aimin Chen, K.S. Joseph, Sharon Kirmeyer, Joyce Martin, Alan Ryan, and Andrea Sharma, with special thanks to Patricia Dietz. The committee also commissioned additional analyses of data from both Denmark and the United States. We thank our consultants, Amy Herring, Ellen Aagaard Nohr, and Cheryl Stein for these analyses and for their contributions to the committee’s work. The committee also felt that it was important to understand what would be involved in analyzing the trade-off between mother and infant in risk of adverse outcomes of variation in weight gain during pregnancy. To accomplish this, we commissioned such an analysis based on the data at hand. We thank our consultant, James Hammitt, for conducting these analyses and for his contribution to the committee’s work.

The committee’s 14 members gave freely of their expertise and volunteered their time and energy in all aspects of the preparation of this report, from developing its intellectual framework, writing the text, and deliberating about the recommendations and conclusions of the report. Their efforts merit our sincere gratitude.

The committee received excellent staff support from Ann Yaktine, Study Director, Heather Del Valle, Research Associate, and Jennifer Datiles, Senior Program Assistant. Their effort on our behalf is sincerely appreciated. We also thank Leslie Pray for technical editing and Florence Poillon for copyediting. Both the Director of the Food and Nutrition Board, Linda Meyers, and the Director of the Board on Children, Youth, and Families, Rosemary Chalk, contributed their wisdom and support to this effort, and we thank them for it.

Kathleen M. Rasmussen, Chair

Committee to Reexamine IOM Pregnancy Weight Guidelines

Copyright © 2009, National Academy of Sciences.
Bookshelf ID: NBK32804

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