The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #67148

Padmini Parthasarathy, MPH, Family, Maternal & Child Health Programs, Contra Costa Health Services, 597 Center Avenue, Suite 365, Martinez, CA 94553, (925) 313-6178, pparthas@hsd.co.contra-costa.ca.us, Barbara F Abrams, DrPH, RD, School of Public Health, Division of Public Health Biology and Epidemiology, University of California, Berkeley, 140 Warren Hall, Berkeley, CA 94720, and Steve Selvin, PhD, School of Public Health, Division of Biostatistics, University of California, Berkeley, 140 Warren Hall, Berkeley, CA 94720.

The Institute of Medicine (IOM) recommends that women with normal body mass indexes (BMIs) gain 11.5-16 kg during pregnancy. This study examined whether the IOM guideline for gestational weight gain in normal BMI women provides an adequate balance between maternal and infant health outcomes. The study sample included 1,086 women whose infants received well baby care from 1997 to 1999 at a San Diego naval base. Data was collected through self-administered questionnaires, medical records, and clinic visits. Multiple linear regression and multiple logistic regression were used to investigate relationships between gestational weight gain categories (low, recommended, and high) and four different outcomes—birthweight, cesarean section, postpartum weigh retention, and postpartum overweight status. Half of the sample gained above the IOM recommendation. Low weight gain did not protect against cesarean section or postpartum weight retention or increase the risk of low birthweight. High weight gain not only increased the likelihood of cesarean section or postpartum overweight, it did not protect infants against low birthweight. However, Black women who gained above the guidelines retained less weight postpartum than those who gained within. These findings suggest that the IOM’s recommendation is valid in terms of infant birthweight and cesarean section, however racial and ethnic differences in weight gain and retention need to be explored further. Understanding the impact of the IOM recommendation is vital to developing interventions and policies to ensure that normal weight women will not become overweight after pregnancy and be faced with increased risks of serious chronic illness and disability.

Learning Objectives:

At the conclusion of the session, participants will be able to:
• Understand the impact of gestational weight gain above the Institute of Medicine recommendation on the balance between maternal and infant outcomes, specifically infant birthweight, cesarean section, postpartum weight retention, and postpartum overweight status.
• Evaluate the validity and appropriateness of the Institute of Medicine recommendation on gestational weight gain.
• Describe program and policy implications of high gestational weight gain among normal weight women.

Keywords: Pregnancy Outcomes, Weight Management

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.