Routine Use of a Prenatal Weight Gain Curve Improves Patient-Provider Communication on Weight Gain Guidelines [12R]

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Abstract

INTRODUCTION:

We sought to increase patient and provider knowledge of recommended weight gain during pregnancy and improve consistency and satisfaction related to weight gain counseling.

METHODS:

We assigned two obstetric (OB) practices as intervention clinics and two clinics as controls. Intervention clinics provided new OB patients with a handout outlining the 2009 Institute of Medicine (IOM) recommendations on prenatal weight gain, and risks of insufficient or excess gain. Prenatal weight gain curves (per IOM guidelines) were utilized at each prenatal visit to visually plot weight gain, and the graphs were reviewed with patients as an objective counseling tool. Providers and patients completed surveys, at baseline and in the third trimester, respectively.

RESULTS:

Baseline provider surveys indicate no difference between clinics in frequency of weight gain discussions. Only 43% of providers report consistent counseling, 18% correctly report IOM guidelines for obese patients, and few counsel on risks of insufficient or excess gain (16% and 19%). 332 patients with a singleton pregnancy (149 control and 183 intervention) completed surveys. Patients at intervention clinics were more likely to report accurate counseling on weight gain (92.3% vs 66.4, P<.001), and discussion reviewing risks of inadequate/excess gain (64.3% vs 51.5%, P=.040). Intervention patients were more satisfied with sensitive weight gain discussions (83.1% vs 64.3%, P=.007).

CONCLUSION:

Use of a visual prenatal weight gain curve as a consistent communication tool increased provider discussions about weight gain and associated risks, and increased patient satisfaction. Implementing its routine use is an effective method to increase counseling.

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