Association Between Obstetric Provider’s Advice and Gestational Weight Gain
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Objective This study examined associations between pregnant women’s report of obstetric provider GWG advice, self-reported adherence to such advice, and GWG. Methods Healthy pregnant women (N = 91) who started obstetric care prior to 17 weeks of gestation completed assessments between 30 and 34 weeks of gestation. These included survey (questions on receipt of and adherence to provider GWG advice, and demographics) and anthropometric measures. GWG data were abstracted from electronic health records. Analyses included Chi square and Mann–Whitney tests, and binary and multivariate logistic regressions. Results The cohort’s median age was 28 years, 68% of women were White, 78% had a college education, 50.5% were overweight or obese before the pregnancy, and 62.6% had GWGs above the Institute of Medicine-recommended ranges. Sixty-seven percent of women reported having received GWG advice from their obstetric providers and, of those, 54.1% reported that they followed their provider’s advice. Controlling for race, education and pre-pregnancy BMI, receipt of GWG advice was marginally associated with increased odds of excessive weight gain (OR 2.52, CI 0.89–7.16). However, women that reported following the advice had lower odds of excessive GWG (OR 0.18, CI 0.03–0.91) and, on average, gained 11.3 pounds less than those who reported following the advice somewhat or not at all. Conclusions Frequency of GWG advice from obstetric providers is less than optimal. When given and followed, provider advice may reduce the risk of excessive GWG. Research to understand factors that facilitate providers GWG advice giving and women’s adherence to providers’ advice, and to develop interventions to optimize both, is needed.
KeywordsProvider advice Gestational weight gain Pregnancy
Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR000161, NIH/NIMHD (Grant #1 P60 MD006912-02), the CDC (Grant # U48 DP001933) and NIH-National Institute of General Medical Science (Grant # 5 R25 GM113686-02). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
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Conflict of interest
The authors declare that they have no conflict of interests.
- American Pregnancy Association. (2016). Fetal Development: Third Trimester. Retrieved February 5, 2018, from http://americanpregnancy.org/while-pregnant/third-trimester/.
- Committee on Nutritional Status During Pregnancy, Institute of Medicine (Eds.). Nutrition during pregnancy: Part I: Weight Gain, Part II: Nutrient Supplements. (1990). Washington, D.C.: National Academy Press.Google Scholar
- Duthie, E., Drew, E., & Flynn, K. (2013). Patient-provider communication about gestational weight gain among nulliparous women: a qualitative study of the views of obstetricians and first-time pregnant women. BMC Pregnancy Childbirth. https://doi.org/10.1186/1471-2393-13-231.PubMedPubMedCentralGoogle Scholar
- Kieffer, E., Carman, W., Gillespie, B., Nolan, G., Worley, S., & Guzman, J. (2001). Obesity and gestational diabetes among African-American women and Latinas in Detroit: Implications for disparities in women’s health. Journal of the American Medical Women’s Association, 56(4), 181–187.PubMedGoogle Scholar
- Moore Simas, T., Waring, M., Sullivan, G., Lio, X., Rosal, M., Hardy, J., & Berry, R. (2013). Institute of medicine 2009 gestational weight gain guideline knowledge: Survey of obstetrics/gynecology and family medicine residents of the United States. Birth, 40(4), 237–246.CrossRefPubMedPubMedCentralGoogle Scholar
- MooreSimas, T., Corvera, S., Lee, M., Zhang, N., Leung, K., Olendzki, B., … Rosal, M. (2015). Understanding multifactorial influences on the continuum of maternal weight trajectories in pregnancy and early postpartum: Study protocol, and participant baseline characteristics. BMC Pregnancy Childbirth, 15, 71.CrossRefGoogle Scholar
- Rasmussen, K. M., & Yaktine, A. L. (2009). Weight gain during pregnancy: Examining the guidelines. Washington, D.C.: Institute of Medicine and National Research Council of the National Academies.Google Scholar