Abstract
Objectives In 2009 the IOM revised prenatal weight gain guidelines. The primary purpose of this pilot study was to assess if provider education and use of prenatal weight gain charts to track weight gain and counsel patients was associated with better patient and provider knowledge and communication about the guidelines. Methods A prospective non-randomized study conducted in four OB practices (two control, two intervention). Data sources included provider surveys (n = 16 intervention, 21 control), patient surveys (n = 332), and medical records. Intervention clinics received provider education on the IOM guidelines and used patient education materials and prenatal weight gain charts to track weight gain and as a counseling tool. Comparison clinics received no education and did not use the charts or patient education information. Results More patients at intervention clinics (92.3%) reported that a provider gave them advice about weight gain, compared to patients from comparison clinics (66.4%) (p < 0.001). Intervention patients were also more likely to report satisfaction discussions with their provider about weight gain (83.1 vs. 64.3%, p = 0.007). Intervention clinic patients were more likely to have knowledge of the guidelines indicated by 72.3% reporting a target weight gain amount within the guidelines versus 50.4% of comparison patients (p < 0.001). Conclusion Provider education and use of weight gain charts resulted in higher patient reported communication about weight gain from their provider, higher patient satisfaction with those discussions, and better knowledge of the appropriate target weight gain goals.
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References
Adamo, K. B., et al. (2013). The maternal obesity management (MOM) trial protocol: A lifestyle intervention during pregnancy to minimize downstream obesity. Contemporary Clinical Trials, 35(1), 87–96.
American College of Obstetricians and Gynecologists (2013) ACOG Committee opinion no. 548: Weight gain during pregnancy. Obstetrics and Gynecology, 121(1), 210–212.
Chang, T., et al. (2013) Perspectives about and approaches to weight gain in pregnancy: A qualitative study of physicians and nurse midwives. BMC Pregnancy Childbirth, 13, 47.
Chung, J. G., et al. (2013). Gestational weight gain and adverse pregnancy outcomes in a nulliparous cohort. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 167(2), 149–153.
Cogswell, M. E., et al. (1999). Medically advised, mother’s personal target, and actual weight gain during pregnancy. Obstetrics and Gynecology, 94(4), 616–622.
Dalenius, K., et al. (2012) Pregnancy nutrition surveillance 2010 report. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.
Davenport, M. H., et al. (2013). Timing of excessive pregnancy-related weight gain and offspring adiposity at birth. Obstetrics and Gynecology, 122(2 Pt 1), 255–261.
Drehmer, M., et al. (2013). Association of second and third trimester weight gain in pregnancy with maternal and fetal outcomes. PLOS ONE, 8(1), e54704.
Ferrari, R. M., & Siega-Riz, A. M. (2013). Provider advice about pregnancy weight gain and adequacy of weight gain. Maternal and Child Health Journal, 17(2), 256–264.
Ferraro, Z. M., et al. (2012). Excessive gestational weight gain predicts large for gestational age neonates independent of maternal body mass index. The Journal of Maternal-fetal & Neonatal Medicine: The Official Journal of The European Association of Perinatal Medicine, The Federation of Asia and Oceania Perinatal Societies, The International Society of Perinatal Obstetricians, 25(5), 538–542.
Heaman, M., et al. (2013). Risk factors for preterm birth and small-for-gestational-age births among Canadian women. Paediatric and Perinatal Epidemiology, 27(1), 54–61.
Healthy People 2020 (2014) Retrieved October 18, 2014, from http://www.healthypeople.gov/2020/topicsobjectives2020/default.aspx.
Institute of Medicine (US), National Research Council. (2009) Weight gain during pregnancy: Reexamining the guidelines. Washington, D.C.: The National Academies Press.
Kessels, R. P. C. (2003). Patients’ memory for medical information. Journal of the Royal Society of Medicine, 96(5), 219–222.
Knight-Agarwal, C. R., et al. (2014). The views and attitudes of health professionals providing antenatal care to women with a high BMI: A qualitative research study. Women and Birth: Journal of the Australian College of Midwives, 27(2), 138–144.
Kominiarek, M. A., Gay, F., & Peacock, N. (2015). Obesity in pregnancy: A qualitative approach to inform an intervention for patients and providers. Maternal and Child Health Journal, 19(8), 1698–1712.
Lutsiv, O., et al. (2012). Little congruence between health care provider and patient perceptions of counselling on gestational weight gain. Journal of Obstetrics and Gynaecology Canada, 34(6), 518–524.
McDonald, S. D., et al. (2011). Despite 2009 guidelines, few women report being counseled correctly about weight gain during pregnancy. American Journal of Obstetrics and Gynecology, 205(4), 333e1–e6.
McDonald, S. D., et al. (2012). Comparison of midwifery, family medicine, and obstetric patients’ understanding of weight gain during pregnancy: A minority of women report correct counselling. Journal of Obstetrics and Gynaecology Canada, 34(2), 129–135.
Muktabhant, B., et al. (2012). Interventions for preventing excessive weight gain during pregnancy. Cochrane Database of Systematic Reviews, 4, CD007145.
N. C. Department of Health and Human Services. (2013) Prenatal weight gain chart: Pre-pregnancy normal weight BMI 18.5–24.9. Retrieved January 26, 2016, from http://www.nutritionnc.com/wic/pdf/NormalWeightSingletonGestationWeightGainChart.pdf.
Nehring, I., Lehmann, S., & von Kries, R. (2013). Gestational weight gain in accordance to the IOM/NRC criteria and the risk for childhood overweight: A meta-analysis. Pediatric Obesity, 8(3), 218–224.
Oken, E., et al. (2013). A qualitative study of gestational weight gain counseling and tracking. Maternal and Child Health Journal, 17(8), 1508–1517.
Olson, C. M., Strawderman, M. S., & Reed, R. G. (2004). Efficacy of an intervention to prevent excessive gestational weight gain. American Journal of Obstetrics and Gynecology, 191(2), 530–536.
Overcash, R. T., & Lacoursiere, D. Y. (2014). The clinical approach to obesity in pregnancy. Clinical Obstetrics and Gynecology, 57(3), 485–500.
Phelan, S., et al. (2011). Practitioner advice and gestational weight gain. Journal of Women’s Health, 20(4), 585–591.
Siega-Riz, A. M., & Gray, G. L. (2013). Gestational weight gain recommendations in the context of the obesity epidemic. Nutrition Reviews, 71(Suppl 1), S26–S30.
Stewart, Z. A., Wallace, E., & Allan, C. (2012). Weight gain in pregnancy: A survey of current practices in a teaching hospital. The Australian & New Zealand Journal of Obstetrics & Gynaecology, 52(2), 208–210.
Stotland, N. E., et al. (2005). Body mass indec, provider advice, and target gestational weight gain. Obstetrics and Gynecology, 105(3), 633–638.
Stotland, N. E., et al. (2006). Gestational weight gain and adverse neonatal outcome among term infants. Obstetrics and Gynecology, 108(3), 635–643.
Tanentsapf, I., Heitmann, B. L., & Adegboye, A. R. E. (2011). Systematic review of clinical trials on dietary interventions to prevent excessive weight gain during pregnancy among normal weight, overweight and obese women. BMC Pregnancy and Childbirth, 11, 81.
Thangaratinam, S. et al. (2012). Effects of interventions in pregnancy on maternal weight and obstetric outcomes: Meta-analysis of randomised evidence. BMJ, 344, e2088.
Thangaratinam, S. et al. (2012). Interventions to reduce or prevent obesity in pregnant women: A systematic review. Health Technology Assessment, 16(31), 1–191.
Waring, M. E. et al. (2014). Patient report of guideline-congruent gestational weight gain advice from prenatal care providers: Differences by prepregnancy BMI. Birth, 41(4), 353–359.
Whitaker, K. M. et al. (2016). Patient and provider perceptions of weight gain, physical activity, and nutrition counseling during pregnancy: A qualitative study. Women’s Health Issues: Official Publication of the Jacobs Institute of Women’s Health, 26(1), 116–122.
Wilkinson, S. A., Poad, D., & Stapleton, H. (2013) Maternal overweight and obesity: A survey of clinicians’ characteristics and attitudes, and their responses to their pregnant clients. BMC Pregnancy Childbirth, 13,117.
Acknowledgements
The authors would like to thank the Abbott Northwestern Foundation for funding this study, Dr. Katherine Jacobs for helping get the project started, the staff of participating clinics for altering their workflow to incorporate the use of the weight gain charts and/or data collection, and Ann Jorgenson for her work entering data from surveys and abstracting data from the medical record.
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This project was funded through a grant from the Abbott Northwestern Hospital Foundation.
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Aguilera, M., Sidebottom, A.C. & McCool, B.R. Examination of Routine Use of Prenatal Weight Gain Charts as a Communication Tool for Providers. Matern Child Health J 21, 1927–1938 (2017). https://doi.org/10.1007/s10995-017-2308-x
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DOI: https://doi.org/10.1007/s10995-017-2308-x