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The researchers reviewed data from a cohort of
10,226 participants enrolled between 1959 and 1965 in the multicenter National
Collaborative Perinatal Project. It was initiated to investigate risk factors
for cerebral palsy at 12 U.S. sites. This study looked at the children born at
full-term gestation, and researchers evaluated socioeconomic and growth data
during gestation, at birth and at age 7. Maternal data were collected at
enrollment by using a questionnaire that included maternal pre-pregnancy weight,
age and race. Maternal weight and height were measured at the time of delivery
to determine gestational weight gain - the difference between the measured
weight at delivery and the reported pre-pregnancy weight.
According to the Institute of Medicine (IOM), which makes recommendations for
weight gain during pregnancy, the amount of weight women should gain during
pregnancy depends on the mother's weight status before pregnancy. Women at a
healthy pre-pregnancy weight are encouraged to gain 25 to 35 pounds, while women
who are overweight should stay between 15 to 25 pounds. Women who are
underweight should gain more weight during pregnancy -- between 28 and 40
pounds.
Of the women studied by the researchers, 11 percent gained excessive weight, 24
percent gained adequate weight and 65 percent gained insufficient weight. Today,
said the researchers, these proportions would be very different, with almost one
in two women gaining more weight than recommended during pregnancy.
The authors say that encouraging pregnant women to adopt healthy eating
practices and engage in aerobic physical activity could help them achieve
appropriate weight gain and also help prevent obesity in their children. They
add that benefits would likewise result from healthy eating and exercise before
becoming pregnant, as well as reducing postpartum weight retention before a
subsequent pregnancy.
Using the IOM guidelines, children whose mothers exceeded the recommended weight
gain were 48 percent more likely to be overweight than children whose mothers
stayed within the recommended weight gain. The risk of overweight was similar
for children born of women who gained insufficient weight compared with mothers
who gained appropriate weight during pregnancy.
The researchers add that more research is necessary to clarify whether the
association between greater gestational weight gain and increased odds of
overweight in offspring is causal, and whether it exists in today's environment
of increasing obesity.
Dr. Wrotniak's coauthors were Justine Shults, Ph.D., of the Center for Clinical
Epidemiology and Biostatistics (CCEB) at the University of Pennsylvania School
of Medicine; Samantha Butts, M.D., M.S.C.E., of the Division of Infertility and
Reproductive Endocrinology at the University of Pennsylvania School of Medicine;
and Nicolas Stettler, M.D., M.S.C.E., of Children's Hospital and the Penn CCEB.
About The Children's Hospital of Philadelphia: The Children's Hospital of
Philadelphia was founded in 1855 as the nation's first pediatric hospital.
Through its long-standing commitment to providing exceptional patient care,
training new generations of pediatric healthcare professionals and pioneering
major research initiatives, Children's Hospital has fostered many discoveries
that have benefited children worldwide. Its pediatric research program is among
the largest in the country, ranking third in National Institutes of Health
funding. In addition, its unique family-centered care and public service
programs have brought the 430-bed hospital recognition as a leading advocate for
children and adolescents.
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