Management of Gestational Weight Gain in Primary Care

Abstract

Excessive weight gain during pregnancy is a risk factor for a number of adverse outcomes for mothers and their babies, including childhood obesity. However, approximately 60% of women gain weight in excess of the recommendations, which are based on pre-pregnancy body mass index (BMI). A number of cultural, socioeconomic and biological factors influence gestational weight gain. In addition, advice from a prenatal care provider has been shown to play an important role. Evidence outside the pregnancy arena shows that when approached in a patient-centered rather than a clinician-centered or prescriptive manner, advice by clinicians promotes increased patient acceptance of and adherence to recommendations, as well as increased intentions for, and attempts at, behaviour change. The Canadian Obesity Network developed the 5As of Healthy Pregnancy Weight Gain, a point-of-care tool to help prenatal care providers address gestational weight gain with their patients. This tool, based on principles of behaviour change science and patient-centeredness, assists clinicians to engage in conversations about weight-related behaviour change with their patients in a systematic manner that incorporates the patient context. Work is currently underway to evaluate the use of the 5As of Healthy Pregnancy Weight Gain, both from providers’ and patients’ perspectives.