The impact of IOM recommendations on gestational weight gain among US women: An analysis of birth records during 2011-2019

If you need an accessible version of this item, please submit a remediation request.
Date
2022-07-21
Language
American English
Embargo Lift Date
Committee Members
Degree
Degree Year
Department
Grantor
Journal Title
Journal ISSN
Volume Title
Found At
Public Library of Science
Abstract

The prevailing guidelines of the Institute of Medicine (IOM) of United States on gestational weight gain (GWG) are based on women's prepregnancy body mass index (BMI) categories. Previous research has shown that the guidelines issued in 1990 and revised in 2009 had no effect. We investigate the effectiveness of new guidelines issued in 2009 analyzing the records of all singleton births in the U.S. during 2011-2019 (34.0 million observations). We use the discontinuity in recommended guidelines at the threshold values of BMI categories in a regression discontinuity (RD) research design to investigate the effect of IOM guidelines on GWG. We also use an RD analysis in a difference in difference (DID) framework where we compare the effect on women who had any prenatal care to others who did not receive prenatal care. The naïve RD estimator predicts an effect in the expected direction at the threshold BMI values of 18.5 and 25.0 but not at 30.0. After the DID based correction, the RD analyses show that the GWG, measured in kg, drop at the BMI values of 18.5, 25.0 and 30.0 by 0.189 [CI: 0.341, 0.037], 0.085 [CI: 0.179, -0.009] and 0.200 [CI: 0.328, 0.072] respectively when the midpoint of the recommended range in kg drops by 1.5, 4.5 and 2.25. This implies a responsiveness of 12.6%, 1.9% and 8.9% respectively to changes in guidelines at these BMI values. The findings show that the national guidelines have induced some behavioral changes among US women during their pregnancy resulting in a change in GWG in the expected direction. However, the magnitude of the change has not been large compared to the expectations, implying that the existing mechanisms to implement these guidelines have not been sufficiently strong.

Description
item.page.description.tableofcontents
item.page.relation.haspart
Cite As
Tennekoon VS. The impact of IOM recommendations on gestational weight gain among US women: An analysis of birth records during 2011-2019. PLOS Glob Public Health. 2022;2(7):e0000815. Published 2022 Jul 21. doi:10.1371/journal.pgph.0000815
ISSN
Publisher
Series/Report
Sponsorship
Major
Extent
Identifier
Relation
Journal
PLoS Global Health
Source
PMC
Alternative Title
Type
Article
Number
Volume
Conference Dates
Conference Host
Conference Location
Conference Name
Conference Panel
Conference Secretariat Location
Version
Final published version
Full Text Available at
This item is under embargo {{howLong}}