Knowledge translation tool to improve pregnant women's awareness of gestational weight gain goals and risks of gaining outside recommendations: a non-randomized intervention study.

Sarah D Mcdonald,Melissa Brouwers,Valerie Mueller,Eleanor Pullenayegum,Joseph Beyene,Binod Neupane,Helen Mcdonald,Christina K Park,Wendy Sword,Keyna Bracken,Valerie H Taylor

doi:10.1186/s12884-015-0534-z

Abstract

BackgroundThere is an urgent need to prevent excessive pregnancy weight gain, a contributor to both maternal and child obesity. However, the majority of women had reported not being counseled to gain an appropriate amount of gestational weight by their health care providers. We developed a knowledge translation (KT) tool designed to facilitate the clinical interaction between pregnant women and their health care providers (HCPs). We piloted the tool on the impact on women’s knowledge of gestational weight gain (GWG) goals, and evaluated its potential in promoting appropriate knowledge about GWG within the 2009 Institute of Medicine guidelines.MethodsWe conducted a prospective cohort study, comparing women’s knowledge about GWG after the KT tool to women from the same clinics and care providers the year prior. Our primary outcome was the proportion of women who reported receiving an appropriate GWG recommendation from their care provider. We evaluated knowledge on a survey conducted at enrollment in the cohort at ≤ 20 weeks gestation and evaluated participant satisfaction with the KT tool in the third trimester. We performed univariate and multivariable logistic regression analyses for differences in outcomes with historical controls from the same clinics. Our a priori sample size calculation required 130 participants to demonstrate a 15% increase in reported counseling about gestational weight gain.ResultsOne hundred and forty-six women were recruited and 131 (90%) completed the enrollment survey. Women who received the KT tool were more likely to report receiving a specific GWG recommendation from their HCP (adjusted odds ratio [AOR] 3.45, 95% confidence interval [CI] 2.22-5.37) and discussing GWG topics with their HCP (AOR 7.96, 95% CI 4.41-14.37), and believing that there were risks to their infants with inadequate GWG (AOR 2.48, 95% CI 1.14-5.37). Half of women (49.5%) indicated that they would recommend the tool to a friend.ConclusionsWomen who received the KT tool reported receiving more counseling on GWG from their HCPs and were more aware of the risks of gaining outside appropriate GWG recommendations. The association between GWG education and GWG requires further research.

Highlights

There is an urgent need to prevent excessive pregnancy weight gain, a contributor to both maternal and child obesity
Other risks of high gestational weight gain (GWG) include being large for gestational age [3] and preterm birth [4] for infants, and postpartum weight retention [5] and cesarean delivery [6] for mothers, which were some of the outcomes considered in the development of the 2009 Institute of Medicine (IOM) gestational weight gain guidelines, along with childhood obesity and small for gestational age [7]
Historical controls were used as data from the same clinics from only one year prior to the present study were available to determine if the knowledge translation (KT) tool improved outcomes in women in the same geographical setting

Summary

Introduction

There is an urgent need to prevent excessive pregnancy weight gain, a contributor to both maternal and child obesity. The majority of women had reported not being counseled to gain an appropriate amount of gestational weight by their health care providers. High weight gain during pregnancy has serious implications, including increased risk of later obesity for both mothers [1] and their infants [2]. Other risks of high gestational weight gain (GWG) include being large for gestational age [3] and preterm birth [4] for infants, and postpartum weight retention [5] and cesarean delivery [6] for mothers, which were some of the outcomes considered in the development of the 2009 Institute of Medicine (IOM) gestational weight gain guidelines, along with childhood obesity and small for gestational age [7]. Over three quarters of practitioners reported that a tool that would calculate GWG would be helpful [10]

Objectives

Methods

Results

Conclusion