Abstract
BackgroundThere has been a rapid increase in the publication of guidelines for managing obesity and weight gain during pregnancy over the past five years. Healthcare professionals have identified multiple barriers to this area of practice, including the need to improve their communication skills, beliefs that pregnant women will have negative reactions to weight-related discussions, and a lack of weight management knowledge. This systematic review aimed to identify: the effectiveness of interventions in changing healthcare professionals’ practice relating to maternal obesity or weight management during pregnancy; and which behaviour change techniques and modes of intervention delivery have been used in interventions to date.FindingsThe search strategy included searching electronic databases, trial registers, and citation searching. Inclusion criteria were intervention studies targeted towards changing healthcare professionals’ practice in relation to maternal obesity or weight management. The searches identified 3,608 studies. However, no eligible completed studies were identified. One registered Canadian randomised controlled trial was identified. The trial includes a training intervention for family physicians with the aim of supporting adherence to gestational weight gain guidelines. The trial had not yet commenced therefore no effectiveness data were available.ConclusionsThe current focus of maternal obesity and weight management research is targeted towards changing pregnant women’s behaviours. These interventions do not address the multiple healthcare professionals’ barriers to maternal obesity and weight management practice. Further research is required to identify the most effective approaches to support healthcare professionals to implement maternal obesity and weight management guidelines into practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-014-0097-9) contains supplementary material, which is available to authorized users.
Highlights
There has been a rapid increase in the publication of guidelines for managing obesity and weight gain during pregnancy over the past five years
Since the publication of the US Institute of Medicine (IoM) gestational weight gain guidelines in 2009 [4], there has been a rapid increase in the development of guidelines for weight management during pregnancy and the care of obese pregnant women in many countries across the world [11,12,13,14,15,16]
Some key barriers to practice were healthcare professionals lack of knowledge, a belief that there would be negative consequences of intervening, and some environment and resource barriers [17]
Summary
There has been a rapid increase in the publication of guidelines for managing obesity and weight gain during pregnancy over the past five years. Healthcare professionals have identified multiple barriers to this area of practice, including the need to improve their communication skills, beliefs that pregnant women will have negative reactions to weight-related discussions, and a lack of weight management knowledge. Obesity in pregnancy is increasing and has significant health implications for pregnant women and their babies These include gestational diabetes, post-partum haemorrhage, infections, stillbirth, congenital anomalies, and the long-term development of obesity and related disease in offspring [1,2,3]. Specific guideline recommendations vary by country of origin, the behaviours targeted towards healthcare professionals (rather than pregnant women) can be broadly grouped into two categories: diagnostic and clinical intervention behaviours (e.g., additional screening for diabetes, anaesthetic reviews); and communication behaviours (e.g., communicating weight status and risk, and providing lifestyle and weight gain advice). Interventions targeted at supporting healthcare professionals are required to help overcome barriers to practice and to facilitate implementation of maternal obesity and weight management guidelines
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