Excerpt

This investigation of future research needs builds on work of the RTI–University of North Carolina at Chapel Hill Evidence-based Practice Center. Their team conducted the systematic evidence review on Outcomes of Maternal Weight Gain released in 2008. The rationale for the review cited specific trends in perinatal health with important public health implications as driving factors for conduct of the review: Since the 1990 Institute of Medicine (IOM) BMI guidelines on weight gain in pregnancy were published, data show that women in the United States are increasingly gaining more weight during pregnancy than recommended; including: excess weight gain among overweight and obese women, overweight and obesity among women of childbearing age are rising as are levels among preschool children, adults tend to gain weight with age so that advancing maternal age contributes to higher prepregnancy body weight, pregnancy complications associated with excess weight, such as gestational diabetes, large-for-gestational-age babies, and cesarean birth, are increasing in prevalence.

Contents

• Preface
• Executive Summary
  • Background
  • Key Questions Addressed by 2008 Systematic Review
  • Methods
  • Results
  • Discussion and Conclusions
• Background
  • 2008 AHRQ Systematic Review of Outcomes of Maternal Weight Gain
  • Key Questions Addressed by 2008 AHRQ Review
  • Change in National Guidelines for Maternal Weight Gain
  • Research Gaps Identified in Prior Work
  • Consideration of Feasible Study Types for Addressing Gaps
  • Summary
• Methods
  • Phase 1 Identifying Recently Completed and Ongoing Studies
  • Engaging Stakeholders, Researchers, Funders
  • Prioritizing Future Research
  • Determining Appropriate and Feasible Study Design
  • Handling Conflicts of Interest
• Results
  • Phase 1 Updating the 2008 SER Literature Review
  • Phase 2 Steps of the Modified Delphi Process
  • Highest Priority Research Questions
  • Phase 3 Optimal Research Designs To Address Top Priority Questions
• Discussion and Conclusions
  • Conclusions
• References
• Abbreviations
• Appendixes
  • Appendix A Search Strategy for Ongoing Studies
  • Appendix B List of Ongoing Studies
  • Appendix C Prioritization Tools and Results
  • Appendix D Excluded Studies

Acknowledgments: We are indebted to an extraordinary team for their work on this report. Specifically: Cheena Clermont provided logistical support and developed the Web-based snowballing platform. Kathy Lee spent hours tracking and organizing documents for this review. We are grateful for her consistency and positive attitude.

AHRQ Contacts: Carolyn M Clancy, MD, Director, Agency for Healthcare Research and Quality; Stephanie Chang, MD, MPH, Director, Evidence-based Practice Center Program, Agency for Healthcare Research and Quality; Jean Slutsky, PA, MSPH, Director, Center for Outcomes and Evidence, Agency for Healthcare Research and Quality; Shilpa H Amin, MD, MBSc, FAAFP, Task Order Officer, Evidence-based Practice Center Program, Agency for Healthcare Research and Quality

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, Contract No. 290-2007-10065-I. Prepared by: Vanderbilt Evidence-based Practice Center, Nashville, TN

Suggested citation:

McKoy JN, Hartmann KE, Jerome RN, Andrews JC, Penson DF. Future Research Needs for Outcomes of Weight Gain in Pregnancy. Future Research Needs Paper No. 6. (Prepared by the Vanderbilt Evidence-based Practice Center under Contract No. 290-2007-10065-I.) AHRQ Publication No. 11-EHC004-EF. Rockville, MD: Agency for Healthcare Research and Quality. November 2010. Available at: www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the Vanderbilt Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10065-I). The findings and conclusions in this document are those of the author(s), who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care researchers and funders of research make well-informed decisions in designing and funding research and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of scientific judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical research and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances.

This report may be used, in whole or in part, as the basis for research design or funding opportunity announcements. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

This information does not represent and should not be construed to represent a determination or policy of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

None of the investigators has any affiliations or financial involvement that conflicts with the material presented in this report.

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