世界卫生组织妊娠期体重增加技术咨询小组第四次会议报告

Report on the Fourth Meeting ofthe WHO TechnicalAdvisory Group onGestational WeightGain Report on The Fourth Meeting of theWHO Technical AdvisoryGroup on GestationalWeight Gain 14–15 November 2024 CONTENTS ACRONYMS................................................................................................................................................ 41.INTRODUCTION.................................................................................................................................. 52.SUMMARY OF DAY 1 PRESENTATIONS AND DISCUSSIONS.................................................................... 6Session 1: GWG protocol......................................................................................................................... 6Session 2: GWG data acquisition and harmonization.............................................................................. 12Session 3: Data quality criteria .............................................................................................................. 173.SUMMARY OF DAY 2 PRESENTATIONS AND DISCUSSIONS ................................................................ 22Session 4: WHO GWG Project publications plan .................................................................................... 22Session 5: Methods for defining recommended weight gain ranges ......................................................... 24Session 6: The revised timeline and 2025 workplan ................................................................................ 26Next steps ............................................................................................................................................ 27Closing remarks.................................................................................................................................... 28ANNEX I. Meeting participants ................................................................................................................... 29ANNEX II. Meeting agenda......................................................................................................................... 30 ACRONYMS ANCAntenatal careAHSFood and Nutrition Actions in Health SystemsBMIBodymassindexCOIConflict of interestDHSDemographic and Health SurveysDSSData sharing standardsGAMLSSGeneralized Additive Models for Location, Scale and ShapeGDMGestational diabetes mellitusGWGGestational weight gainIOMInstitute of MedicineKgKilogramLMPLast menstrual periodMAHMaternal Health UnitMCADepartment Maternal, Newborn, Child and Adolescent Health and AgeingMNFMonitoring Nutrition and Food Safety Events UnitMPHMaternal and Perinatal Health UnitNFSDepartment of Nutrition and Food SafetyPIPrincipal investigatorSRHSexual and Reproductive Health and ResearchSDStandard deviationsSSDStandardized site differenceTAG-GWGTechnical Advisory Group on Gestational Weight GainUSGUltrasonographyWHOWorld Health Organization 1.INTRODUCTION Pregnancy is a unique period in the life cycle for implementing interventions to optimize longer-term maternaland child health. Pregnant women’s frequent contact with the health care system and their strong motivationto optimize their health make pregnancy a critical period where lifestyle factors, such as weightmanagement, can influence outcomes for women and their children. There is a lack of evidence-based public health tools for monitoring gestational weight gain (GWG) that applyto women of all body mass index (BMI) categories and geographic locations. The GWG recommendationsused worldwide and endorsed by the World Health Organization (WHO) in the most recent antenatal care(ANC) guidance1are based on Institute of Medicine (IOM) guidelines, which were developed primarily usingobservational studies from high-income countries. To address this critical gap, WHO initiated a normative process to develop global GWG standards that can beused as a tool for dynamic monitoring during ANC in a diverse range of settings. An important outcome of thisproject will also be the definition of recommended GWG ranges2based on these curves to support thereduction of adverse maternal and infant outcomes. This project is led by the WHO Departments of Nutrition and Food Safety (NFS) and Sexual and ReproductiveHealth and Research (SRH), with contributions from the Department of Maternal, Newborn, Child andAdolescent Health and Ageing (MCA), in partnership with a research group comprised of scientists from theFederal University of Rio de Janeiro (Brazil), Cornell University (United States), and the University of BritishColumbia (Canada). The GWG Steering Committee includes some members of these external institutionsand the WHO Secretariat. In 2023, WHO established a multidisciplinary Technical Advisory Group on Gestational Weight Gain (TAG-GWG) to advise on the process of developing GWG standards and optimal ranges (seeAnnex Ifor details).3This includes providing advice on the development of a detailed resea