Online Program

Panel Discussion

Since the dawn of the public health era, those entrusted with promoting the health of women and children have sought to determine the ideal gestational weight gain (GWG) for maximizing the likelihood of positive health outcomes during infancy. Perhaps the best informed of such attempts is the Institute of Medicine’s (IOM) guidelines. These guidelines, which are specific to a woman’s pre-pregnancy Body Mass Index (BMI), recommend the amount of weight a woman should gain to optimize health of her fetus and, by extension, her infant. Extant evidence, including work by our team, has linked inadequate GWG (as determined by IOM guidelines) with a myriad of risks for the fetus and infant; and has linked excessive GWG with risk of poor pregnancy outcomes for the mother. In this special emphasis panel on GWG, we begin with a concise review of the state of science on GWG. Next, we will present findings from three longitudinal population-based epidemiological studies of GWG. Study 1 (Davis, Shenassa, Hofferth) examines whether the independent link between GWG and infant mortality, recently reported by our group, is linked to poor maternal nutrition. Implications of study’s findings for clinical practice will be discussed. Study 2 (DiBari, Shenassa, He) examines the interaction of GWG and feeding type on infant growth. Implications of study’s findings for clinical practice as well as future epidemiologic studies will be discussed. Study 3 (Wen) examines the hypothesis that the 4 components of GWG (i.e., maternal tissue, maternal fluid, fetus, and placenta) have differential impacts on maternal and child outcomes. Results from this study provide guideline on how to IOM’s GWG guidelines can be revised to enhance their utility for epidemiologic studies. Study 4 (Fahey) presents a critical examination of how IOM’s GWG guidelines can be further refined to enhance their utility in clinical practice.

Session Objectives: - Describe some of the latest epidemiologic research on gestational weight gain (GWG) along with discussions related to both epidemiologic research and clinical practice, as detailed below: - Describe evolving perspectives on GWG throughout the public health era. - Assess whether the link between GWG and infant mortality, recently reported by our group, is linked to poor maternal nutrition. - Assess the interaction of GWG and feeding type on infant growth. - Demonstrate differential impacts on MCH outcomes associated with the 4 components of GWG (i.e., maternal tissue, maternal fluid, fetus, and placenta). - Discuss how IOM’s GWG guidelines can be further refined to enhance their utility in clinical practice.