Inconsistent Weight Communication Among Prenatal Healthcare Providers and Patients: A Narrative Review

Abstract

Healthcare providers should counsel their pregnant patients on GWG with advice that is concordant with the Institute of Medicine Guidelines.

A Pilot Study Evaluating the Effectiveness of the 5As of Healthy Pregnancy Weight Gain

“…Most HCPs agreed that the 5As gave them more knowledge and confidence to discuss GWG with their patients. The barriers to addressing GWG reported by the HCPs in this study were concordant with barriers reported in a recent narrative review, 24 in which HCPs perceived that GWG counseling may be ineffective or were uncertain whether their role involves GWG counseling. In this study, obstetricians indicated barriers such as competing medical issues more often than midwives, whereas midwives more frequently indicated worries about their patient becoming upset if GWG was discussed.…”

“…Of note, study participants had a low prevalence of preexisting medical conditions, which, if present, might have taken precedence over GWG discussions. Although HCPs are considered one of the most reliable sources of prenatal information, 24 we found that women reported weight gain information through external sources such as the internet, friends, family, books, and/or previous personal experience. The use of such external sources may provide a reason as to why pregnant women may not be interested in initiating discussions of weight gain preemptively with their HCPs.…”

“…22,23 Current prenatal HCP-mediated GWG counseling appears to be insufficient with respect to content, frequency, and accuracy. 24 A recent literature review examining patient and provider perceptions of GWG communication noted that more HCPs self-reported discussing GWG with their patients than patients reported being counseled in care. 24 Additionally, women of higher socioeconomic status, of older age, who were nulliparous, who had a history of dieting and low physical activity, and who were categorized as overweight or obese were more likely to receive GWG advice, thus showing that GWG does not always occur equally.…”

“…24 A recent literature review examining patient and provider perceptions of GWG communication noted that more HCPs self-reported discussing GWG with their patients than patients reported being counseled in care. 24 Additionally, women of higher socioeconomic status, of older age, who were nulliparous, who had a history of dieting and low physical activity, and who were categorized as overweight or obese were more likely to receive GWG advice, thus showing that GWG does not always occur equally. Knowledge translation aides, such as evidence-based smartphone applications for pregnant women, or electronic health records with GWG trackers for HCPs may be valuable in improving GWG counseling and pregnancy outcomes.…”

MAMMA MIA! Norwegian Midwives’ Practices and Views About Gestational Weight Gain, Physical Activity, and Nutrition

“…Studies have also shown that prenatal nutrition and related lifestyle counseling throughout gestation may lower GWG and neonatal macrosomia, especially in a high-risk population, such as women with overweight or obesity (Mitchell et al, 2017;Peccei et al, 2017). Hence, healthcare providers have the potential to influence and be a reliable source of evidence-based health information during an important period of a woman's life (Weeks et al, 2018). de Jersey et al (2018) found that a brief education session integrated into an existing mandatory training program has shown positive results in improving the knowledge and confidence of midwives in delivering advice and support for healthy GWG.…”