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Health Officials Issue Revised Pregnancy Weight-Gain Guidelines For Obese Women
The Institute of Medicine and the National Research Council on Thursday issued revised U.S. weight-gain guidelines for obese pregnant women, in response to rising levels of obesity in the country and growing evidence that weight gain can cause health problems for women and their infants, the New York Times reports. The revision, which is the first since 1990, recommends that obese women -- those with a body mass index of 30 or more -- limit their weight gain to 11 to 20 pounds over nine months. The 1990 pregnancy guidelines did not specifically address weight gain for obese women, telling them instead to follow the recommendations for overweight women. According to health officials, the changes to the recommendations for obese women were required to keep up with the changing weight patterns among women in the U.S. The New York Times reports that about 27% of women of childbearing age are considered obese, while 55% fall into the categories of overweight or obese.The recommendations for women with BMIs of less than 30 did not change. They call for overweight women -- those with a BMI of 25 to 29.9 -- to gain 15 to 25 pounds over nine months, while underweight women -- with BMIs of less than 18.5 -- should gain 28 to 40 pounds, and normal-weight women -- with BMIs of 18.6 to 24.9 -- should gain 25 to 35 pounds (Parker-Pope, New York Times, 5/29).Time reports that pregnant women who do not gain enough weight face a higher risk of stunted fetal growth and preterm delivery. However, it is more common for women to gain too much weight, placing them at higher risk for conditions like gestational diabetes and high blood pressure. In addition, their infants are at increased risk of being born earlier, larger and by cesarean section. Time reports that excessive weight gain can increase a woman"s risk of postpartum obesity and elevate risks of heart disease and stroke because most women do not lose extra pounds gained during pregnancy. Many studies also have suggested that a woman"s gestational weight can predict potential weight problems in her offspring (Kingsbury, Time, 5/28).The committee that developed and issued the revision said that the existing guidelines were essentially on target but that women and their physicians need to work harder to help women reach a normal weight before pregnancy and avoid gaining too much weight during pregnancy, according to the Los Angeles Times (Roan, Los Angeles Times, 5/29). The guidelines also recommend more nutrition and exercise counseling during pregnancy, advising physicians or midwives to consult dieticians to shape a woman"s care regardless of her initial weight, the AP/Yahoo! News reports (Neergaard, AP/Yahoo! News, 5/28). The Los Angeles Times reports that health care professionals are expected to recognize and implement some of the recommendations; however, it is not mandatory to do so.Several experts on maternal obesity and child health expressed disappointment with the guidelines, arguing that obese women should gain little to no weight during pregnancy, according to the Los Angeles Times. They also argue the new guidelines do not do enough to address obesity before pregnancy. Maxine Hayes, state health officer for the Washington State Department of Health, said, "If we wait for every woman to be advised about weight gain after they become pregnant, it"s too late. It puts women and their babies on a trajectory that is unhealthy" (Los Angeles Times, 5/29).
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Media Coverage Generates 47% Increase In Melanoma Diagnoses
Media coverage of skin cancer advice and sun awareness campaigns may have generated a 47 percent increase in diagnoses of melanoma in just one year, according to research due to be released at the British Association of Dermatologists" Annual Conference next week.
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Experts Support National Public Reporting Of Healthcare-Associated Infections
Five organizations representing the nation"s experts in infectious diseases medicine, infection prevention in healthcare settings, and public health and disease prevention announced their support for a provision requiring national reporting of healthcare-associated infection (HAI) rates, which is contained within the healthcare reform bill introduced by leaders of the U.S. House of Representatives.
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Finance Committee Senators: Reform Bill Trimmed To Less Than $1 Trillion

Some senators on the Finance Committee said Thursday they"ve moved closer to cutting their health reform bill"s cost to under $1 trillion. The New York Times: "Senator Kent Conrad, Democrat of North Dakota, said the overall cost of the bill had been reduced mainly by limiting eligibility for various subsidies. Assistance would originally have been available to people with incomes up to 400 percent of the poverty level ($88,200 for a family of four). Democrats have lowered the ceiling to 300 percent of the poverty level ($66,150 for a family of four)." "But as senators leave town for a weeklong Fourth of July break, Democrats are nowhere near where they had hoped to be. The Democrats had hoped that two Senate committees would approve the legislation by the end of this week. The measure could affect nearly every family, employer and health care provider in the country." The bill is also likely to include mandates on employers to provide insurance for their employees, to tax those benefits and to scale back Medicare payment rates. "Senators said the cost of the bill might also be reduced by dropping or scaling back a plan to give tax credits to small businesses, to help them buy insurance. (Sen. Max) Baucus, (D-Mont.,) like House Democrats, wants to expand Medicaid to cover millions more people. But to save money, he and other Senate Democrats may delay the start of the expansion for three years, to 2013." Republicans in the Senate Finance Committee hoped to have a deal announced Thursday, but instead promised to keep working (Pear, 6/25). The goal now is to finish a bill shortly after the 4th of July recess that is deficit-neutral, Baucus said, according to The Washington Post. "As described by aides and lawmakers on the Senate Finance Committee, the financing package includes substantial reductions in future spending on Medicare and Medicaid, the primary federal health programs for elderly and low-income people. In addition to trimming payments to hospitals and other providers, the panel is considering empowering an existing federal agency, known as MedPAC, to monitor Medicare costs and make adjustments unless Congress objects. The shift would take much Medicare authority out of the political process, diminishing the health-care industry"s lobbying power" (Murray and Montgomery, 6/26). The Associated Press: ""There"s not a final bill that"s agreed to. What there is now is a clear path to having a bill that is paid for," said Sen. Kent Conrad, D-N.D., one of seven Republican and Democratic Finance Committee senators who"ve been working closely on the deal. Baucus has dubbed the group "the coalition of the willing." All seven issued a brief, joint statement later Thursday claiming progress, even though some Republicans involved made no secret of their skepticism." "Aides said the Congressional Budget Office had estimated that the elements under consideration would extend coverage to 97 percent of the population, excluding illegal immigrants" (Werner and Espo, 6/26). Roll Call: "The statement, signed onto by Finance Chairman Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa), comes after a week of furious negotiations on a bipartisan health care bill. Lending their names to the statement were Senate Budget Chairman Kent Conrad (D-N.D.); Health, Education, Labor and Pensions ranking member Mike Enzi (R-Wyo.); and Sens. Jeff Bingaman (D-N.M.), Orrin Hatch (R-Utah) and Olympia Snowe (R-Maine)." "Baucus" enthusiasm is due in part to a recent Congressional Budget Office score of various policy options that puts the costs of a bill at less than $1 trillion over 10 years. The CBO also has scored those options as deficit neutral. Baucus revealed this information to reporters earlier Thursday" (Drucker, 6/25). The Wall Street Journal: "The development came as the CBO issued a new forecast projecting that rising health costs will put increasing pressure on the federal budget. The nonpartisan office projects that if current laws do not change, federal spending on Medicare and Medicaid combined will grow from almost 5% of GDP today to almost 10% by 2035" (Adamy and Hitt, 6/25). Politico: "The early outlines of the Finance Committee package reflect their middle-of-the-road leanings, but also the politics of the Senate, where supermajority deal making is often the only way to move a bill. They are drawing high-level attention, too. White House health reform director Nancy-Ann DeParle spent time Wednesday with the four Republican senators, and promised to bring their message back to the president" (Brown, 6/26). This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org. © Henry J. Kaiser Family Foundation. All rights reserved.


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