Better counseling needed on weight gain in pregnancy

Healthcare providers aren’t giving overweight women proper advice on healthy gestational weight gain and physical activity. That is the conclusion of a small new study by researchers from Penn State College of Medicine in Hershey, Pennsylvania, based on semistructured interviews with overweight and obese women after the birth of a first child.

The analysis, published in Women’s Health Issues, included 24 women, half of whom were overweight (defined as body mass index [BMI] 25-29) and half of whom were obese (BMI>29).

Half the women had been advised by providers to gain too much weight during pregnancy, based on guidelines for women of normal weight rather than for those who are overweight or obese. Weight gain was not discussed with 9 of the 24 women, 1 received nonspecific advice, and only 2 women received advice on appropriate weight gain. All the women, however, had their weight monitored during prenatal visits. Only 10 of the 24 women received advice from providers on exercise during pregnancy.

Three themes on weight gain emerged from the interviews: (1) Women were advised to gain too much weight or given no recommendation on gestational weight gain; (2) Providers were perceived as being unconcerned about excessive gestational weight gain; and (3) Women want and appreciate advice on gestational weight gain from providers.

Additionally, women received limited or no advice on appropriate physical activity during pregnancy. According to lead investigator Cynthia Chuang, “Women received little, if any, feedback regarding whether their weight gain during pregnancy was healthy or not. Some women who ... were seen by different providers in the same practice even received conflicting advice.”

This study, the researchers concluded, suggests that provider advice on gestational weight gain and exercise is insufficient and often inappropriate.

Stengel MR, Kraschnewski JL, Hwang SW, Kjerulff KH, Chuang CH. “What my doctor didn’t tell me”: examining health care provider advice to overweight and obese pregnant women on gestational weight gain and physical activity. Womens Health Issues. 2012;22(6):e535-e540.