INTRODUCTION: The prevalence of obesity among women of reproductive age is increasing. Excess gestational weight gain is associated with increased short- and long-term maternal and neonatal morbidity and mortality. We sought to examine associations between pre-pregnancy body mass index (BMI) and self-suggested gestational weight gain and to identify barriers to achieving an appropriate weight gain in an inner-city population receiving care at a resident-run clinic.
METHODS: From July 2012 to March 2013, 451 surveys were completed by patients at their first prenatal visit before meeting with a provider. Patients reported height and weight, and BMI was calculated.
RESULTS: Sixty-nine percent were African American and 53% stated they received food assistance. Forty percent of women were obese (BMI greater than or equal to 30 kg/m2) with an average BMI of 27.4+/-7.6 standard deviation kg/m2. Seventy-one percent of women did not know their appropriate gestational weight gain, and the higher the BMI, the greater prevalence of overcalling suggested gestational weight gain. Fifty-six percent stated that excessive gestational weight gain was not a problem ( Table 1). Regardless of level of parity, 63% said that their obstetric provider had never spoken to them about gestational weight gain in prior visits ( Table 2); of those, 40% instead heard about gestational weight gain from friends and family. When stratified by BMI category ( Table 3), only 46% of obese patients and 48% of patients with BMI greater than or equal to 40 kg/m2 responded that their health care providers ever discussed gestational weight gain.
(C) 2014 by The American College of Obstetricians and Gynecologists.