Patient Comprehension of Gestational Weight Gain Recommendations and Associated Pregnancy Outcomes [16I

Abstract

INTRODUCTION: Gestational weight gain above the Institute of Medicine guidelines is associated with obstetric and fetal complications. American College of Obstetricians and Gynecologists recommends that weight management begin before conception and continue through the postpartum period. We assessed patients' knowledge of gestational weight gain recommendations and associated outcomes. METHODS: One-hundred-seventy-three women completed a survey at a prenatal visit after 20 weeks gestation. After delivery, a chart review obtained the patient’s starting and ending pregnancy weight and BMI. Pearson Chi-square testing and the Related Samples Wilcoxon Signed Rank test were used. RESULTS: Overall 44% of our studied population were overweight or obese. When assessing physician counseling of weight category, only 39% of women recalled being told their starting BMI (p=0.24). In addition, the majority (59%) reported receiving no counseling on pregnancy outcomes associated with starting BMI or excessive gestational weight gain (p=0.004). Less than one-third of overweight and obese women gained within guidelines (p=0.001), and most gained above guidelines (p=0.001). CONCLUSION: The majority of women gain in excess of guidelines. Excessive weight gain is associated with childhood and maternal health complications, including obesity. Our study shows that few women receive or retain information on weight recommendations and associated risks of excess gain. Not only are women unprepared for the immediate risks posed by excess gain, they are also more likely to retain weight which is a significant contributor to ill-health. Improved patient education could significantly reduce adverse outcomes in the United States related to excessive weight gain.