Provider and Patient Knowledge and Views of Office Practices on Weight Gain and Exercise during Pregnancy
07 April 2017
08 August 2017
08 September 2017 (eFirst)
Objective This study sought to assess provider and patient knowledge and beliefs on gestational weight gain (GWG) and exercise during pregnancy, outline current clinical practices and the perceived value of educational tools.
Study Design Providers and patients at the George Washington Medical Faculty Associates Obstetricians and Gynecologists clinic were recruited for a voluntary survey. Descriptive statistics of responses were compared and chi-square analysis tested for significant associations.
Results A total of 461 patient and 36 provider questionnaires were analyzed. Providers recommended GWG consistent with the Institute of Medicine guidelines for a “normal” body mass index (82.9%); however, a majority (52.8%) recommended GWG below guidelines for obese women. All providers reported counseling patients on GWG, but only 53.4% of patients reported discussing personal recommendations. About half of providers reported distributing educational materials for GWG (60.0%); however, only 30.6% of patients reported receiving them. African American patients self-reported receiving the highest rates of counseling and educational materials, though a lower rate of recommendations to exercise. Patients perceived educational tools to be more useful than did providers.
Conclusion Our findings suggest a gap between provider–patient perceptions regarding counseling and provision of informational materials. Future research should study whether implementing various educational tools might increase the efficacy of current practices.
- 1 Kwon HY, Kwon JY, Park YW, Kim YH. The risk of emergency cesarean section after failure of vaginal delivery according to prepregnancy body mass index or gestational weight gain by the 2009 Institute of Medicine guidelines. Obstet Gynecol Sci 2016; 59 (03) 169-177
- 2 Siega-Riz AM, Viswanathan M, Moos MK. , et al. A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: birthweight, fetal growth, and postpartum weight retention. Am J Obstet Gynecol 2009; 201 (04) 339.e1-339.e14
- 3 Hannaford KE, Tuuli MG, Odibo L, Macones GA, Odibo AO. Gestational weight gain: Association with adverse pregnancy outcomes. Am J Perinatol 2017; 34 (02) 147-154
- 4 Di Mascio D, Magro-Malosso ER, Saccone G, Marhefka GD, Berghella V. Exercise during pregnancy in normal-weight women and risk of preterm birth: a systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol 2016; 215 (05) 561-571
- 5 Nohr EA, Vaeth M, Baker JL, Sørensen TIa, Olsen J, Rasmussen KM. Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. Am J Clin Nutr 2008; 87 (06) 1750-1759
- 6 Samura T, Steer J, Michelis LD, Carroll L, Holland E, Perkins R. Factors associated with excessive gestational weight gain: Review of current literature. Glob Adv Health Med 2016; 5 (01) 87-93
- 7 Johnson JL, Farr SL, Dietz PM, Sharma AJ, Barfield WD, Robbins CL. Trends in gestational weight gain: The pregnancy risk assessment monitoring system, 2000–2009. Am J Obstet Gynecol 2015; 212 (06) 806.e1-806.e8
- 8 Institute of Medicine. Weight gain during pregnancy: Reexamining the guidelines. Washington, DC: The National Academies Press; 2009
- 9 American College of Obstetricians and Gynecologists. ACOG Committee opinion no. 548: weight gain during pregnancy. Obstet Gynecol 2013; 121 (01) 210-212
- 10 ACOG Committee opinion no. 650: physical activity and exercise during pregnancy and the postpartum period. Obstet Gynecol 2015; 126 (06) e135-e142
- 11 Deputy NP, Sharma AJ, Kim SY. Gestational weight gain - United states, 2012 and 2013. Morb Mortal Wkly Rep 2015; 64 (43) 1215-1220
- 12 Huberty JL, Buman MP, Leiferman JA, Bushar J, Adams MA. Trajectories of objectively-measured physical activity and sedentary time over the course of pregnancy in women self-identified as inactive. Prev Med Rep 2016; 3: 353-360
- 13 Magro-Malosso ER, Saccone G, Di Mascio D, Di Tommaso M, Berghella V. Exercise during pregnancy and risk of preterm birth in overweight and obese women: a systematic review and meta-analysis of randomized controlled trials. Acta Obstet Gynecol Scand 2017; 96 (03) 263-273
- 14 Moore Simas TA, Waring ME, Sullivan GMT. , et al. Institute of Medicine 2009 gestational weight gain guideline knowledge: survey of obstetrics/gynecology and family medicine residents of the United States. Birth 2013; 40 (04) 237-246
- 15 Lutsiv O, Bracken K, Pullenayegum E, Sword W, Taylor VH, McDonald SD. Little congruence between health care provider and patient perceptions of counselling on gestational weight gain. J Obstet Gynaecol Can 2012; 34 (06) 518-524
- 16 Wrotniak BH, Dentice S, Mariano K, Salaam EM, Cowley AE, Mauro EM. Counseling about weight gain guidelines and subsequent gestational weight gain. J Womens Health (Larchmt) 2015; 24 (10) 819-824
- 17 Duthie EA, Drew EM, Flynn KE. 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 2013; 13: 231