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.
CONCLUSION: Despite the Institute of Medicine's updated gestational weight gain guidelines (2009), pregnant patients are still unaware of the appropriate amount of weight to gain during pregnancy. One significant modifiable factor reported by patients is the lack of information provided to them by their resident physician. Further resident education is required to bridge the gap between physician knowledge of maternal obesity and patient understanding.
Financial Disclosure: Nyima S. Ali, MD, and Charmaine S. Wright, MD—These authors have no conflicts of interest to disclose relative to the contents of this presentation.
© 2014 by The American College of Obstetricians and Gynecologists.