Increasing Patient Adherence to Gestational Weight Gain Goals in Pregnancy

Abstract Problem: The inability to maintain healthy weight gain during pregnancy may contribute to multiple pregnancy-related complications. Nutritional education and support may improve nutrition and vitamin consumption, and recommendations for healthy gestational weight gains have been published. However, pregnant women have reported minimal advice regarding healthy weight gain during pregnancy. A personalized, nutritional counseling program was initiated in a Midwestern, suburban OB-GYN private practice. Methods: A quality improvement descriptive, correlational design was used. A cohort of pregnant women first trimester through six-weeks postpartum received individual counseling and face-to-face interaction at an office visit each trimester. Results: Twenty (N=20) participated in this project. Most were white (n=17, 80%), married (n=12, 60%), and had private insurance (n=18, 90%) with no Medicaid patients. With logistic regression analysis, 55% of women who received individual weight counseling gained less than five pounds above recommendations. Subjects were 85.7% more likely to achieve recommended weight gain when nutrition counseling was given (OR=1.857, p = 0.187). Patient enrollment and postpartum weights were compared using a Wilcoxon Matched-Pairs analysis (Z= -1.980, p=0.048). Implications for practice: Healthcare providers who assist women during pregnancy to achieve a recommended weight gain based on their body mass index (BMI) with counseling and expanded nutritional support may contribute to women being more successful at achieving recommended weight gain goals during pregnancy. Personal nutritional counseling appeared to have benefited women across all weight classes, however, further study is needed with a more diverse population