Pregnancy Weight Gain Guidelines May be Revised

The Institute of Medicine has launched a project to reevaluate recommendations for weight gain in pregnancy, and held its first meeting to discuss the topic on January 17th, with representatives from the Maternal and Child Health Bureau, National Institute of Child Health and Human Development, March of Dimes, Centers for Disease Control and Prevention, Office of Women’s Health, and other agencies in attendance.

The committee in charge of the project has several stated goals, including a review of the evidence on weight gain and maternal and child health outcomes, identifying gaps in that evidence and defining research priorities, and reconsidering current approaches to the topic of weight gain in pregnancy.

Notably, the committee plans to take into account racial/ethnic and age differences and health indicators beyond the BMI, rather than applying a one-size-fits-all approach. Adolescents and women carrying multiples may also receive special consideration. The last IOM report and guidelines on this topic, issued in 1990, defined appropriate weight gain by BMI, allowing more weight gain for those with low body mass indices to gain more weight than those with higher BMIs. According to a news item on the meeting, one attendee from the National Institutes of health reminded the committee:

"that 'BMI classifications are screens; they are not themselves diagnostic.' Not everyone in a certain range is at a healthy weight, he said. There are people in the 20-25 kg/m2 range who have all the manifestations and adverse effects of obesity, and there are people in a higher BMI group who could be called overweight or obese but have no adverse health effects, he emphasized."

The attendees also noted that weight gain above the recommended amount isn't the only problem, as the number of women with inadequate weight gain and prevalence of low birth weight have also risen in recent years.