Michael L Power1,2, Maria Gaspar-Oishi3, Kelly Gibson4, Elizabeth W Kelly5, Melisa L Lott6, A Dhanya Mackeen6, Rachael T Overcash7, Courtney P Rhoades8, Mark Turrentine9, Yasuko Yamamura10, Jay Schulkin1,11. 1. Department of Research, American College of Obstetricians and Gynecologists, Washington, District of Columbia. 2. Smithsonian National Conservation Biology Institute, Washington, District of Columbia. 3. Department of Obstetrics and Gynecology, Kapiolani Medical Center, University of Hawaii, Honolulu, Hawaii. 4. Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio. 5. Department of Obstetrics and Gynecology, Albany Medical Center Obstetrics and Gynecology, Albany, New York. 6. Geisinger Health System, Danville, Pennsylvania. 7. MedStar Washington Hospital Center, Washington, District of Columbia. 8. Department of Obstetrics and Gynecology, Methodist Hospital Dallas, Dallas, Texas. 9. Department of Obstetrics and Gynecology, Kelsey-Seybold Clinic, Houston, Texas. 10. Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, Minnesota. 11. Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington.
Abstract
Background: Inappropriate gestational weight gain (GWG) is prevalent in the United States. About 20% of women gain below Institute of Medicine (IOM) recommendations; more than 50% gain above. GWG outside of recommendations is linked to poor birth outcomes and health issues for mother and baby. Counseling by health care providers is important to encourage appropriate GWG. Methods: Assess patient recall of counseling regarding GWG, provider knowledge, and opinions about IOM GWG guidance, and GWG outcomes in a subset of women. Cross-sectional, with questionnaires distributed by 8 medical centers across the United States to patients. Questionnaires were distributed to providers and data on maternal body mass index (BMI) and GWG collected at seven sites. Results: A total of 1,157 women returned questionnaires (1,820 maximum possible). A majority at all sites reported a provider discussed their expected GWG with them. Close to half reported that a provider had discussed potential harms from inappropriate GWG. Most of the women (71.2%) considered their obstetrician to be a helpful resource for GWG advice. Most providers (87.5%) reported they were aware of IOM guidelines. As many providers disagreed (18.8%) as agreed (20.8%) that they were successful helping their patients attain appropriate GWG (58.3% were neutral). Physician self-reported confidence was associated with whether they believed they could help their patients avoid excessive GWG. The most common outcome was GWG above recommendations (51.4%). Overweight and obese women were more likely to gain above recommendations. Providers underestimated the proportion of their patients that gained below IOM recommendations (8.5% vs. 18.6%). Conclusions: Providers are aware of the dangers of excessive GWG and a majority of patients report receiving counseling. Providers appear more cognizant of excessive GWG and underestimate inadequate GWG. Most women are not achieving an appropriate GWG, with overweight and obese women especially likely to gain above recommendations.
Background: Inappropriate gestational weight gain (GWG) is prevalent in the United States. About 20% of women gain below Institute of Medicine (IOM) recommendations; more than 50% gain above. GWG outside of recommendations is linked to poor birth outcomes and health issues for mother and baby. Counseling by health care providers is important to encourage appropriate GWG. Methods: Assess patient recall of counseling regarding GWG, provider knowledge, and opinions about IOM GWG guidance, and GWG outcomes in a subset of women. Cross-sectional, with questionnaires distributed by 8 medical centers across the United States to patients. Questionnaires were distributed to providers and data on maternal body mass index (BMI) and GWG collected at seven sites. Results: A total of 1,157 women returned questionnaires (1,820 maximum possible). A majority at all sites reported a provider discussed their expected GWG with them. Close to half reported that a provider had discussed potential harms from inappropriate GWG. Most of the women (71.2%) considered their obstetrician to be a helpful resource for GWG advice. Most providers (87.5%) reported they were aware of IOM guidelines. As many providers disagreed (18.8%) as agreed (20.8%) that they were successful helping their patients attain appropriate GWG (58.3% were neutral). Physician self-reported confidence was associated with whether they believed they could help their patients avoid excessive GWG. The most common outcome was GWG above recommendations (51.4%). Overweight and obesewomen were more likely to gain above recommendations. Providers underestimated the proportion of their patients that gained below IOM recommendations (8.5% vs. 18.6%). Conclusions: Providers are aware of the dangers of excessive GWG and a majority of patients report receiving counseling. Providers appear more cognizant of excessive GWG and underestimate inadequate GWG. Most women are not achieving an appropriate GWG, with overweight and obesewomen especially likely to gain above recommendations.
Authors: Sara E Long; Melanie H Jacobson; Yuyan Wang; Mengling Liu; Yelena Afanasyeva; Susan J Sumner; Susan McRitchie; David R Kirchner; Sara G Brubaker; Shilpi S Mehta-Lee; Linda G Kahn; Leonardo Trasande Journal: Int J Obes (Lond) Date: 2022-04-11 Impact factor: 5.551