Inconsistent Weight Communication Among Prenatal Healthcare Providers and Patients: A Narrative Review

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ImportanceGestational weight gain (GWG) is an independent and modifiable factor for a healthy pregnancy. Gestational weight gain above or below the Institute of Medicine Guidelines has been shown to impact both maternal and fetal health (eg, gestational diabetes, hypertension, downstream obesity). Healthcare providers (HCPs) have the potential to be reliable sources of evidence-based weight information and advice during pregnancy.ObjectiveThe aim of this study was to summarize the literature assessing GWG discussions between patients and their HCPs in a clinical setting to better understand the knowledge that is currently being exchanged.Evidence AcquisitionA literature review was conducted by searching Ovid Medline, CINAHL, and Embase databases. All relevant primary research articles in English that assessed GWG discussions were included, whereas intervention studies were excluded.ResultsA total of 54 articles were included in this review. Although the overall prevalence and content of GWG counseling varied between studies, counseling was often infrequent and inaccurate. Healthcare providers tended to focus more on women experiencing obesity and excessive GWG, as opposed to the other body mass index categories or inadequate GWG. Women of higher socioeconomic status, older age, nulliparous, history of dieting, low physical activity, and those categorized as overweight/obese were more likely to receive GWG advice. Patients also reported receiving conflicting facts between different HCP disciplines.ConclusionsThe evidence regarding GWG counseling in prenatal care remains variable, with discrepancies between geographic regions, patient populations, and HCP disciplines.RelevanceHealthcare providers should counsel their pregnant patients on GWG with advice that is concordant with the Institute of Medicine Guidelines.Target AudienceObstetricians and gynecologists, family physicians, midwives, and prenatal healthcare providers.Learning ObjectivesAfter completing this activity, the learner should be better able to critique the gaps in prenatal health education regarding GWG, assess the impact that various HCPs have on a patient's weight gain practices, and distinguish factors that contribute to useful and helpful GWG counseling.

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