A STAKEHOLDER EXAMINATION OF GESTATIONAL WEIGHT GAIN GUIDELINES

Obesity is a significant health concern for women of childbearing age. More than 40% of women have a Body Mass Index (BMI) in the overweight or obese ranges at the time they conceive, posing significant health risks for both mother and child. Excessive weight gain during pregnancy is common and associated with numerous deleterious complications. The Institute of Medicine published gestational weight gain (GWG) guidelines based on prepregnancy BMI. However, more than 50% of women gain in excess of these recommendations. Further, many women report receiving minimal guidance from their healthcare providers regarding weight gain, nutrition, and physical activity during pregnancy. There is a clear need to enhance patient-provider communication to develop relevant and targeted interventions to reduce excessive GWG. The current study used a mixed-methods approach to assess perspectives of both pregnant and postpartum women, and obstetric healthcare providers (HCPs’). Interviews with pregnant and postpartum women with overweight or obesity prior to pregnancy indicated deference to providers regarding GWG. However, many women indicated suboptimal receipt of GWG information, disagreement with the GWG guidelines, and disapproval of the restrictive weight ranges for women in higher BMI categories. Additionally, parity emerged as a salient topic for women, especially as related to weight retention between pregnancies. HCPs’ survey data suggest systemic barriers to patient-provider communication (e.g. time, training) could serve as targets for future interventions. In sum, maternal overweight and obesity, excessive GWG, and patient-provider interaction are crucial topics to address to improve maternal and fetal outcomes, and decrease healthcare costs