Weight management during pregnancy: a qualitative thematic analysis on knowledge, perceptions and experiences of overweight and obese women in Singapore

Abstract

Background: The effect of maternal weight on pregnancy and birth outcomes is of great public health concern. For example, overweight and obesity among pregnant women is associated with adverse reproductive health outcomes including gestational diabetes, birth defects, macrosomia and infant mortality.Objectives: To understand the knowledge, perceptions and experiences during pregnancy among overweight and obese women in Singapore.Methods: This is a cross-sectional study which employed qualitative techniques. The inclusion criteria is as follows: (1) Women who were overweight or obese before or during first trimester of pregnancy, (2) are able to report their specific pre-pregnancy or first trimester Body Mass Index (BMI), or weight and height, (3) had singleton pregnancy when overweight, are post-delivery for the pregnancy in which they were overweight, and (4) are 21 to 55 years old. Fifteen interviews were voice-recorded and transcribed verbatim. Then, two researchers independently performed the thematic analysis of the transcripts.Results: The findings revealed that women had gaps in knowledge on the adverse effects of maternal overweight and obesity during pregnancy, and various misconceptions on diet and weight management during pregnancy were prevalent. Conflicting data was obtained for perceptions on the importance, difficulty and levels of motivation for weight management during pregnancy.Conclusion: There is a pressing need to address knowledge gaps and misconceptions of pregnant women who are overweight or obese. The importance of weight management during pregnancy should be emphasized, and enabling factors put in place.

Empirical validation of the information-motivation-behavioral skills model of gestational weight management behavior: a framework for intervention

“…Our results confirmed this, indicating the multiple roles of information in influencing healthy behaviors. Previous qualitative studies found that pregnant women were not aware of the adverse effects of overweight or obesity during pregnancy, and misunderstanding about gestational diet and weight management [ 38 , 39 ]. A quantitative survey in Australia also revealed that pregnant women have insufficient knowledge of the Institute of Medicine gestational weight gain guidelines and pregnancy-specific dietary recommendations [ 40 ].…”

Management of prepregnancy, pregnancy, and postpartum obesity from the FIGO Pregnancy and Non‐Communicable Diseases Committee: A FIGO (International Federation of Gynecology and Obstetrics) guideline

“…Women with obesity may be unaware of the extent of adverse health outcomes of pregnancy that are related to obesity and may hold misconceptions about the relationship between diet, weight, and health in pregnancy 40–42 . Advice should be given to women with obesity of the effect on their fertility and the risks of obesity during pregnancy and childbirth, which include neural tube defects, macrosomia, preterm delivery, stillbirth, shoulder dystocia, cesarean delivery, GDM, metabolic syndrome, sleep apnea, hypertension, and thromboembolic disorders 37,43–45 .…”

Prenatal care experiences among pregnant women with obesity in Wisconsin, United States: a qualitative quality improvement assessment

“…Given the risks related to having a BMI ≥ 40 kg/m 2 during pregnancy for both the mother and the developing fetus, additional screening or testing, such as growth ultrasounds, are often recommended [23,24]. Indeed, prior investigations evaluating patient perceptions and knowledge of the risks of having a high BMI on pregnancy demonstrate consistent gaps in knowledge on the adverse effects of a woman having a high BMI on pregnancy outcomes [25]; knowledge gaps are also prevalent regarding gestational weight gain recommendations [21,[25][26][27][28]. Obstetric providers should inform pregnant women with BMIs ≥40 kg/m 2 about the indications for any additional tests, the limitations of ultrasounds, and the risks of having a high BMI for maternal and fetal pregnancy outcomes [24].…”