Association Between Obstetric Provider\u27s Advice and Gestational Weight Gain

Objective This study examined associations between pregnant women\u27s report of obstetric provider GWG advice, self-reported adherence to such advice, and GWG. Methods Healthy pregnant women (N = 91) who started obstetric care prior to 17 weeks of gestation completed assessments between 30 and 34 weeks of gestation. These included survey (questions on receipt of and adherence to provider GWG advice, and demographics) and anthropometric measures. GWG data were abstracted from electronic health records. Analyses included Chi square and Mann-Whitney tests, and binary and multivariate logistic regressions. Results The cohort\u27s median age was 28 years, 68% of women were White, 78% had a college education, 50.5% were overweight or obese before the pregnancy, and 62.6% had GWGs above the Institute of Medicine-recommended ranges. Sixty-seven percent of women reported having received GWG advice from their obstetric providers and, of those, 54.1% reported that they followed their provider\u27s advice. Controlling for race, education and pre-pregnancy BMI, receipt of GWG advice was marginally associated with increased odds of excessive weight gain (OR 2.52, CI 0.89-7.16). However, women that reported following the advice had lower odds of excessive GWG (OR 0.18, CI 0.03-0.91) and, on average, gained 11.3 pounds less than those who reported following the advice somewhat or not at all. Conclusions Frequency of GWG advice from obstetric providers is less than optimal. When given and followed, provider advice may reduce the risk of excessive GWG. Research to understand factors that facilitate providers GWG advice giving and women\u27s adherence to providers\u27 advice, and to develop interventions to optimize both, is needed