Beliefs, Barriers, and Preferences of European Overweight Women to Adopt a Healthier Lifestyle in Pregnancy to Minimize Risk of Developing Gestational Diabetes Mellitus: An Explorative Study

Abstract

Introduction. We explored beliefs, perceived barriers, and preferences regarding lifestyle changes among overweight European pregnant women to help inform the development of future lifestyle interventions in the prevention of gestational diabetes mellitus. Methods. An explorative mixed methods, two-staged study was conducted to gather information from pregnant European women (BMI ≥ 25 kg/m2). In three European countries 21 interviews were conducted, followed by 71 questionnaires in six other European countries. Content analysis and descriptive and chi-square statistics were applied (p < 0.05). Results. Women preferred to obtain detailed information about their personal risk. The health of their baby was a major motivating factor. Perceived barriers for physical activity included pregnancy-specific issues such as tiredness and experiencing physical complaints. Insufficient time was a barrier more frequently reported by women with children. Abstaining from snacking was identified as a challenge for the majority of women, especially for those without children. Women preferred to obtain support from their partner, as well as health professionals and valued flexible lifestyle programs. Conclusions. Healthcare professionals need to inform overweight pregnant women about their personal risk, discuss lifestyle modification, and assist in weight management. Lifestyle programs should be tailored to the individual, taking into account barriers experienced by overweight first-time mothers and multipara women.

Socio-ecological determinants of lifestyle behavior of women with overweight or obesity before, during and after pregnancy: qualitative interview analysis in the Netherlands

“…The findings of period specific determinants are especially relevant when supporting women to adopt a healthy lifestyle continuously in the periods before, during and after pregnancy. The determinants of lifestyle behavior in the pregnancy and postpartum periods are in line with the findings described before [16][17][18][19][20][21][22][23][24]39]. The current research is an important addition to the existing knowledge in identifying preconception period specific determinants.…”

“…When considering previous studies on determinants of lifestyle behavior conducted in women of childbearing age, survey studies showed that women wishing to become pregnant were interested in lifestyle programs, especially when tailored to the possibilities within the daily life of women [14,15]. During pregnancy, health of the unborn child was an important motivator for adopting a healthy lifestyle [16][17][18]. On the other hand, pregnant women mentioned that being pregnant is a justification for not worrying about weight and pregnancy is a time to eat for two [16].…”

The Perspectives of Pregnant Women on Health-Promoting Behaviors: An Integrative Systematic Review

“…However, they faced barriers that made changes beyond their control. Furthermore, a lack of time especially in multiparous women and being unable to establish communication with nurse assistants for various reasons were mentioned as main barriers (33,36). According to some studies, the training program, the implementation of risk assessment (39,40), customer-centered interventions, short-term motivational interviews, or an increased frequency of being exposed to individuals were facilitators to adopting healthy behaviors (5).…”

“…The existence of traditional perspectives in providing healthcare services and men's lack of participation in prenatal care were considered as barriers to the fulfillment of health behaviors (33). Women believed facilitating factors such as having the opportunity to talk to nurse assistants and having various options in terms of time, location and other communication channels (face-to-face interview, telephone and internet) could affect behavioral changes (33,36).…”

Gestational diabetes mellitus treatment reduces obesity-induced adverse pregnancy and neonatal outcomes: the St. Carlos gestational study

“…While designing the appropriate lifestyle for EWw, the attention should focus on the content itself (a healthy diet, performance of regular physical activity…) but it is also detrimental to facilitate the adherence to this change. A main goal should be to consider counseling as a key aspect, where these women should be educated about GDM risks, as well as discussing individual impediments they might encounter to fulfill the lifestyle changes 28. In addition, providing all pregnant women with the same interventional tools used for GDM treatment, regardless of their GDM condition or PPBMI, should be envisioned as a possible universal clinical practice.…”