Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, 725 Martin Luther King, Jr. Blvd., Campus Box 7590, Chapel Hill, NC 27599-7590, USA.
Matern Child Health J. 2013 Feb;17(2):256-64. doi: 10.1007/s10995-012-0969-z.
To explore the association between health care provider advice about weight gain and gestational weight gain. Using data from a prospective cohort study, we explored the association between provider advice about weight gain in pregnancy with weight gain adequacy among 1,454 pregnant women. Provider advice was measured by maternal self-report at 27-30 weeks' gestation. Linear and Poisson regression were used to explore associations. Seventy-eight percent of the women gained outside current recommendations. Fifty-one percent reported receiving weight gain advice from a health care provider. Adjusted Generalized Linear Model (GLM) estimates showed weak effect of provider advice on inadequate or excessive gain (Relative Risk (RR) 0.96, 95% CI 0.74, 1.26 for inadequate gain and RR 1.01, 95% CI 0.97, 1.06 for excessive gain). There is a need for more women to hear about their targeted weight gains during pregnancy and the present advice that exists does little to influence actual gains. Further studies are warranted to find better strategies for providers to motivate their patients to gain weight within the appropriate ranges.
探讨医疗保健提供者关于体重增加的建议与妊娠期体重增加之间的关系。本研究使用前瞻性队列研究的数据,探索了 1454 名孕妇在妊娠 27-30 周时,由产妇自我报告的提供者关于体重增加的建议与体重增加适当性之间的关系。线性和泊松回归用于探索相关性。78%的女性体重增加超出了当前建议。51%的女性报告从医疗保健提供者那里获得了体重增加建议。调整后的广义线性模型(GLM)估计显示,提供者的建议对体重增加不足或过多的影响较弱(体重增加不足的相对风险(RR)为 0.96,95%CI 为 0.74,1.26,体重增加过多的 RR 为 1.01,95%CI 为 0.97,1.06)。需要让更多的女性在怀孕期间了解到她们的目标体重增加,而目前存在的建议几乎没有影响实际的体重增加。需要进一步研究,以寻找更好的策略,让提供者激励患者在适当的范围内增加体重。