Nutrition During Pregnancy Part I: Weight Gain, Part II: Nutrient Supplements (1990) / Chapter Skim
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Appendixes
Appendixes
Pages 421-440
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From page 423... ...
RECOMMENDED CHARACTERISTICS OF GESTATIONAL WEIGHT GAIN CHARTS The subcommittee recommends that a new gestational weight gain chart be developed with the following characteristics and supporting materials: 1. Gestational age, i.e., weeks from last normal menstrual period, on the horizontal axis, and achieved weight, i.e., total body weight in kilograms or pounds, on the vertical axis.
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From page 424... ...
Such guidelines should be established in the same way as the upper and lower limits of achieved weight, i.e., as either statistical measures of the normative population or as empirically derived cutoff values to discriminate favorable from unfavorable outcomes. The criteria may best be presented as a table of acceptable rates of gain to accompany the gestational weight gain chart.
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From page 425... ...
1b establish an optimal or ideal range of prepregnancy weight and gestational weight gain, one needs to sample a population that experiences both desirable and undesirable pregnancy outcomes. Most of the current reference curves for gestational weight gain are based on data for women who had favorable outcomes, i.e., healthy, full-term infants with normal birth weights.
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From page 426... ...
, such as prepregnancy weight, accumulated weight gain to a specific stage of pregnancy, or rate of weight gain during specific trimesters of pregnancy. Moreover, the distribution of gestational weight gain in the three subpopulations representing the range of fetal growth is likely to be different for women with different prepregnancy weights.
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From page 427... ...
However, an analysis that considers prepregnancy weight in identifying an optimal range for gestational weight gain requires application of sophisticated statistical methods, because prepregnancy weight plays two roles in the causal chain leading to some outcomes: it has an independent effect on fetal growth, and it modifies the effect of gestational weight gain on fetal growth (Figure 2-2, Chapter 2~. The degree of overlap among the three distributions illustrated in Figure A-1 is relatively easy to analyze, if it is not necessary to assume complex relationships of prepregnancy weight and gestational weight gain to outcomes.
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From page 428... ...
There are no weight velocity curves for monitoring pregnancy in healthy adult women, but some have been developed for the assessment of pregnancies in teenagers (Hediger et al., 1989~. The research proposed here would provide the basic information needed to construct clinically useful gestational weight gain charts.
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Spends B Pro~siona1 Debt Gain Embark by Preprognan~ Body Hass Index (BRIG 429
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From page 430... ...
430 APPENDIX B A For Normal Weight Women with BMI of 19.8 to 26.0 (Metric~a 50 40 30 ._ 20 10 o 1 st 2nd 3rd l l TARGET: 15.5 TO 16 kg (25 to 35 lb)
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For Overweight Women with BMI of >26.0 to 29.0 (Metric)
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From page 433... ...
Appendix CTable for Estimating Body Mass Index (Metricya by Using Either Metric or English Measurements of Prepregnangy Weight and Height; BMIs < 19.8 = low; BMIs 26.1 - 29.0 = high; BMIs > 29.0 = obesity (see shaded area above heavy line)
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434 it.
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From page 437... ...
Berkowitz, Ph.D., is perinatal epidemiologist and associate professor in the Department of Obstetrics, Gynecology, and Reproductive Science and the Department of Community Medicine at Mount Sinai School of Medicine, New York. She has conducted various research studies on preterm delivery and intrauterine growth retardation and has written about the role of environmental and occupational hazards during pregnancy.
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From page 438... ...
She has conducted research on lung development and on fat digestion and absorption, emphasizing the ontogeny of digestive enzymes and compensatory digestive function in pancreatic insufficiency, lipid clearance, the composition of human milk and the function of its components in the neonate.
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From page 439... ...
In animals, she has studied the effect of dietary changes on pregnancy outcome and lactation performance, focusing on changes in maternal body composition. In humans, she has studied the relationship of birth weight to maternal body weight and pregnancy weight changes in teenage mothers and in mothers bearing twins.
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From page 440... ...
A neonatologist, he has served as director of Newborn Services and medical director of the Neonatal Intensive Care Unit at University Hospital, Denver. Scientific interests include the physiology, metabolism, and nutrition of the fetus and newborn.
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